后路椎弓根钉棒系统内固定术治疗退变性脊柱侧弯的临床价值  

The value of posterior pedicle screw rod system internal fixation in the treatment of degenerative scoliosis

作　　者：刘志强 冯大雄 周云龙[2] 田龙 周庆忠 郑礼鹏 Liu Zhiqiang;Feng Daxiong;Zhou Yunlong;Tian Long;Zhou Qingzhong;Zheng Lipeng(Department of Spine Surgery,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,China;Department of Spine Surgery,the People's Hospital of Leshan,Leshan 614000,China)

机构地区：[1]西南医科大学附属医院脊柱外科,泸州646000 [2]四川省乐山市人民医院脊柱外科,614000

出　　处：《中国医师杂志》2020年第3期394-397,共4页Journal of Chinese Physician

摘　　要：目的探讨短节段融合和长节段融合分别联合后路椎弓根螺钉系统内固定术治疗退变性脊柱侧弯的临床价值。方法选择2014年1月至2018年2月在西南医科大学附属医院就诊的退变性脊柱侧弯患者74例作为研究对象,采用随机数字表法将患者分为A组和B组各37例。A组采用短节段融合联合后路椎弓根螺钉系统内固定术治疗,B组采用长节段融合联合后路椎弓根螺钉系统内固定术治疗。观察2组患者术前、术后1周、术后3、6个月侧弯Cobb角、脊柱冠状面和矢状面平衡,统计2组术后早期和远期并发症发生率。结果B组术后1周、术后3、6个月Cobb角均小于A组(P<0.05),差异有统计学意义。术后1周、3个月2组冠状面和矢状面平衡比较差异无统计学意义(P>0.05),术后6个月2组冠状面和矢状面平衡比较差异有统计学意义(P<0.05)。2组术后早期并发症发生率比较差异无统计学意义(P>0.05)。2组术后断棒/钉、假关节形成、临近节段病变比较差异无统计学意义(P>0.05),2组冠状面失平衡、侧凸进展比较差异均有统计学意义(P<0.05)。结论长节段融合联合后路椎弓根螺钉系统内固定术治疗退变性脊柱侧弯可改善患者Cobb角,降低术后侧凸进展发生,但易出现冠状面和矢状面失平衡,临床可根据实际情况选择。Objective To investigate the clinical value of short segment fusion and long segment fusion combined with posterior pedicle screw system internal fixation in the treatment of degenerative scoliosis.Methods 74 patients with degenerative scoliosis who were treated in the Affiliated Hospital of Southwest Medical University from January 2014 to February 2018 were enrolled in the study.The patients were divided into group A and group B with a random number table of 37 cases each.Group A was treated with short segment fusion and posterior pedicle screw system internal fixation,while group B was with long segment fusion and posterior pedicle screw system internal fixation.The Cobb angle of scoliosis,the balance of coronal and sagittal plane of spine were observed before operation,1 week after operation,3 months after operation and 6 months after operation,and the incidence of early and long-term complications were counted.Results The Cobb angle of scoliosis in group B was lower than that of group A at 1 week,3 months and 6 months after operation(P<0.05).There was no significant difference in the balance of coronal plane and sagittal plane between the two groups at 1 week and 3 months after operation(P>0.05).There was significant difference in the balance of coronal plane and sagittal plane between the two groups at 6 months after operation(P<0.05).There was no significant difference in the incidence of early postoperative complications between the two groups(P>0.05).Conclusions Long segment fusion and posterior pedicle screw system internal fixation can improve the Cobb angle and reduce the incidence of postoperative scoliosis,but it is easy to appear the imbalance of coronal and sagittal planes,which can be selected according to the actual situation.

关 键 词：椎弓根钉 脊柱融合术 退变性脊柱侧弯 

分 类 号：R687.3[医药卫生—骨科学]