极外侧椎间融合术治疗退变性脊柱侧凸临床观察  

The clinical observation of extreme lateral interbody fusion in degenerative scoliosis

作　　者：陈涛[1] 刘彬[1] 

机构地区：[1]彭州市人民医院骨科,四川彭州611930

出　　处：《临床和实验医学杂志》2016年第10期1013-1016,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的评价极外侧椎间融合术（XLIF）治疗退变性脊柱侧凸的临床疗效。方法收集2013年3月至2014年6月接受XLIF手术的退变性脊柱侧凸患者15例,术前和末次随访以视觉模拟评分（VAS）和日本骨科协会（JOA）评分评价主观症状改善,分别于术前、术后、末次随访时进行CT检查,影像学参数选取冠状位Cobb角、顶椎偏移、节段前凸角、全脊柱前凸角、椎间隙高度、椎间孔高度和椎间孔宽度进行评价。结果所有患者均顺利完成手术,无伤口感染、脑脊液漏、血管腹腔脏器及神经损伤、死亡病例,平均随访时间为14.5个月（11-16）,5例（33.3%）出现手术并发症;患者末次随访时VAS和JOA评分均较术前下降,组内比较差异有统计学意义（P〈0.05）;术后冠状位Cobb角、节段前凸角、全脊柱前凸角、椎间隙高度、椎间孔高度、椎间孔宽度均较术前增加,顶椎偏移较术前减小,组内前后比较差异有统计学意义（P〈0.05）;至末次随访时各指标无明显变化,组内前后比较差异无统计学意义（P〉0.05）。结论 XLIF能有效改善退变性脊柱侧凸患者临床症状,并发症发生率低于传统术式,对冠状位畸形影像学有明显改善,但矢状位矫正疗效需要更多的研究支持。Objective To evaluate clinical efficacy of extreme lateral interbody fusion（ XLIF） for degenerative scoliosis. Methods From March 2013 to June 2014,15 patients diagnosed with degenerative scoliosis in our hospital administered XLIF. Improvement of subjective symptoms evaluated by visual analogue scale（ VAS） and Japanese Orthopaedic Association（ JOA） score in preoperative and last follow- up respectively. Radiographic evaluation of coronal Cobb angle,apical vertebral translation,segmental lordosis,global lordosis,disc height,foraminal height and foramen width were evaluated by CT scan in preoperative,post- operation and last follow- up. Results All patients operated successfully,none complained of wound infection,cerebrospinal fluid leakage,vascular abdominal organs and nerve damage,deaths. The average follow- up time were 14. 5 months. 5 patients（ 33. 3%） turned up complications. In last follow- up,VAS and JOA scores decreased obviously compared to pre- operation（ P〈0. 05）. In post- operation,coronal Cobb angle,segmental lordosis,global lordosis,disc height,foraminal height and foramen width increased compared to pre- operation（ P〈0. 05）. Apical vertebral translation reduced compared to pre- operation（ P 〈0.05）. There was no significant changes in last follow- up compared to post- operation in the indexes（ P〉0. 05）. Conclusion XLIF improve clinical symptoms of degenerative scoliosis effectively and the complication rate is lower than traditional operation. Image of coronal deformity improve significantly,but correction efficacy of sagittal sequence needed more research.

关 键 词：退变性脊柱侧凸 极外侧椎间融合术 矫正 

分 类 号：R687.3[医药卫生—骨科学]