后路松解椎间支撑植骨对退变性脊柱侧弯的治疗效果评价  

Effect of posterior release and interbody structural bone grafting in the treatment of degenerative scoliosis

作　　者：张银顺[1] 陶晖[1] 董福龙[1] 钱军[1] 李伟[1] 章仁杰[1] 刘畅[1] 杨庆国[1] 申才良[1] ZHANG Yin-shun;TAO Hui;DONG Fu-long;QIAN Jun;LI Wei;ZHANG Ren-jie;LIU Chang;YANG Qing-guo;SHEN Cai-liang(Department of Orthopedics,the First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China)

机构地区：[1]安徽医科大学第一附属医院骨科脊柱外科病区,安徽合肥230022

出　　处：《颈腰痛杂志》2020年第3期293-295,共3页The Journal of Cervicodynia and Lumbodynia

基　　金：安徽省高校自然科学研究重点项目(编号:KJ2019A0242)。

摘　　要：目的探讨后路松解椎间支撑植骨治疗退变性脊柱侧弯的临床效果。方法选取2016年3月-2018年7月在安徽医科大学第一附属医院脊柱外科行后路松解椎间支撑植骨治疗的退变性脊柱侧弯患者29例进行回顾性研究;记录其手术时间、术中出血量及术后并发症情况,应用Oswestry功能障碍指数问卷表(Oswestry disability index,ODI)对患者腰椎功能进行评估,应用视觉模拟评分法(visual analogue scale,VAS)评估患者疼痛程度,测量术前术后及随访时侧弯Cobb角。结果患者术前侧弯Cobb角平均26.0°(15-41°),术后侧弯矫正率平均70.8%;随访时间(23.2±5.7)个月,随访期间无内固定失败、松动等,侧弯矫正度无明显丢失;术前ODI指数和VAS评分分别为(61.0±11.7)%和(5.9±1.5)分,末次随访时ODI指数和VAS评分分别为(18.9±4.0)%和(1.1±0.8)分,均较术前明显改善(P<0.05)。结论后路松解椎间支撑植骨对退变性脊柱侧弯的矫正效果明显,能较好地重建患者冠状面和矢状面平衡,改善其功能障碍,缓解疼痛。Objective To study the effect of posterior release and interbody structural bone grafting in the treatment of degenerative scoliosis.Methods From March 2016 to July 2018,29 patients with degenerative scoliosis who were treated in the spinal department of the First Affiliated Hospital of Anhui Medical University with structural bone grafting were selected in the retrospective study.The operative time,intraoperative blood loss and postoperative complications were recorded.The Oswestry disability index(ODI)was used to evaluate the lumbar spine function,the visual analogue scale(VAS)was used to evaluate the pain degree,and the Cobb's angle of the scoliosis was measured pre-operation,post-operation and during follow-up.Results Preoperative Cobb's angle was averagely 26.0°(15°-41°),the scoliosis correction rate was 70.8%on average.The postoperative follow-up time was(23.2±5.7)months,no internal fixation failure,loosening and correction loss occurred.The preoperative ODI and VAS scores were(61.0±11.7)%and(5.9±1.5)respectively.The ODI and VAS scores were(18.9±4.0)%and(1.1±0.8)at the last follow-up,which were significantly improved compared with preoperation(P<0.05).Conclusions Posterior release and interbody structural bone grafting has significant effect on the correction of degenerative scoliosis,and it can reconstruct the balance of the patients’spine on coronal and sagittal plane,improve the function of patients,and relieve the pain.

关 键 词：后路松解 椎间 支撑植骨 退变性脊柱侧弯 功能障碍 

分 类 号：R687.3[医药卫生—骨科学]