有限长节段融合固定治疗退变性下腰段侧凸的临床研究  

A clinical study on limited long-segment fusion for degenerative lower lumbar scoliosis

作　　者：唐翔宇[1] 苏晓静[1] 姚子明[1] 杜建伟[1] 王景明[1] 张永刚[1] 

机构地区：[1]解放军总医院骨科,北京100853

出　　处：《中国骨与关节杂志》2015年第7期564-567,共4页Chinese Journal of Bone and Joint

摘　　要：目的探讨有限长节段融合固定治疗无严重胸腰段后凸的退变性下腰段侧凸的可行性。方法回顾研究2003年6月至2012年9月,于我院接受脊柱手术的退变性下腰段侧凸患者36例,男10例,女26例,平均年龄59.7（55-73）岁。侧凸顶点L3-4,端椎为L2或L3,T10-L2后凸角〈20°,其中有限长节段融合固定组（上端椎L2）16例,长节段融合固定组（上端椎T9-11）20例,对比两组术前及末次随访的影像学参数及Oswestry功能障碍评分。结果有限长节段固定组与长节段固定组比较,腰椎弯曲Cobb’s角、腰椎前凸角、骨盆倾斜角、骶骨倾斜角、T10-L2后凸角、近端交界性后凸角及Oswestry功能障碍评分等指标术前及末次随访,差异无统计学意义（P〉0.05）;有限长节段融合固定组未发生术后近端交界性后凸。结论有限长节段融合固定可用于治疗无严重胸腰段后凸的退变性下腰段侧凸。Objective To explore the feasibility of limited long-segment fusion for the patients with degenerative lower lumbar scoliosis but no severe thoracolumbar kyphosis.Methods Thirty-six patients with degenerative lower lumbar scoliosis who underwent spinal surgery from June 2003 to September 2012 were included in this retrospective study.There were 10 males and 26 females,whose average age was 59.7 years old（ range：55-73 years）.The apical vertebrae was from L3 to L4 and the end vertebrae was L2 or L3,with T10-L2 kyphosis 20°.They were divided into limited long-segment fusion group（ n=16,upper end vertebrae L2） and long-segment fusion group（ n=20,upper end vertebrae T9-11）.The radiographic parameters and Oswestry disability index（ ODI） scores were compared between the 2 groups preoperatively and in the latest follow-up.Results There were no statistically significant differences between the 2 groups preoperatively and in the latest follow-up in lumbar Cobb＇s angle,lumbar lordosis,pelvic tilt,sacral slope,T10-L2 kyphosis,proximal junctional kyphosis and ODI scores（ P〉0.05）.No proximal junctional kyphosis was found in the limited long-segment fusion group.Conclusions The limited long-segment fusion is effective for the patients with degenerative lower lumbar scoliosis but no severe thoracolumbar kyphosis.

关 键 词：脊柱弯曲 脊柱侧凸 外科手术 脊柱融合术 

分 类 号：R687.3[医药卫生—骨科学]