后路减压椎间植骨融合术对退变性腰椎滑脱症脊柱骨盆参数的临床效果研究  

Clinical effect of posterior decompression and interbody fusion on spinal and pelvic parameters of degenerative lumbar spondylolisthesis

作　　者：贺亮[1] HE Liang(Department of Spine Surgery,The Zaozhuang Municipal Hospital,Zaozhuang,Shandong 277101,China)

机构地区：[1]枣庄市立医院脊柱外科,山东枣庄277101

出　　处：《中国伤残医学》2020年第16期1-3,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨后路减压椎间植骨融合术对退变性腰椎滑脱症脊柱骨盆参数的影响及疗效。方法:选取我院2016年1月-2018年1月收治的80例退变性腰椎滑脱症患者,经MRI、X线、CT等检查确诊,均存在不同程度的腰痛、下肢麻木、间歇性跛行等典型症状,根据不同治疗分为2组,对照组(n=40)接受腰椎后外侧融合术治疗,观察组(n=40)接受后路减压椎间植骨融合术治疗,对比2组患者治疗前后疼痛程度和脊柱功能障碍情况以及脊柱骨盆参数和腰椎滑脱相关参数。结果:治疗后2组患者VAS评分均明显降低,观察组下降程度明显大于对照组(P<0.05)。治疗后2组患者ODI评分均明显降低,观察组下降程度明显大于对照组(P<0.05)。治疗前2组患者骶骨倾斜角、骨盆投射角、骨盆倾斜角、腰椎前凸角、脊柱-骨盆角、C7矢状位平衡、胸腰椎联合角、腰椎后凸角对比无差异(P>0.05);治疗后观察组骶骨倾斜角、腰椎前凸角、脊柱-骨盆角、明显大于对照组,骨盆倾斜角、C7矢状位平衡明显小于对照组(P<0.05);治疗后2组患者胸腰椎联合角、腰椎后凸角、骨盆投射角对比无差异(P>0.05)。治疗前2组患者滑脱角、滑移百分数、椎间隙高度对比无差异(P>0.05);治疗后观察组滑脱角、滑移百分数、椎间隙高度明显小于对照组(P<0.05)。结论:后路减压椎间植骨融合术不仅能改善脊柱功能障碍,促进椎间融合,还能降低患者痛苦,值得临床推广。Objective:To investigate the effect of posterior decompression and interbody fusion on spinal and pelvic parameters of degenerative lumbar spondylolisthesis.Methods:80 patients with degenerative lumbar spondylolisthesis admitted to our hospital from January 2016 to January 2018 were diagnosed by MRI,X-ray and CT.All patients had typical symptoms such as low back pain,numbness of lower limbs and intermittent claudication.They were divided into two groups according to different treatments.The control group(n=40)received posterolateral lumbar fusion.The observation group(n=40)received posterior decompression and interbody fusion.The pain degree,spinal dysfunction,spinal pelvic parameters and lumbar spondylolisthesis parameters were compared between the two groups before and after treatment.Results:After treatment,the VAS scores of both groups were significantly decreased,and the decrease degree of observation group was significantly greater than that of control group(P<0.05).After treatment,the ODI scores of both groups were significantly decreased,and the degree of decline in the observation group was significantly higher than that in the control group(P<0.05).Before treatment,there was no difference in sacral inclination angle,pelvic projection angle,pelvic inclination angle,lumbar lordosis angle,spine-pelvic angle,C7 sagittal balance,thoracolumbar joint angle and lumbar kyphosis angle between the two groups(P>0.05);after treatment,the sacral inclination angle,lumbar lordosis angle,spine-pelvis angle in the observation group were significantly larger than those in the control group,and the bone was significantly larger than that in the control group.The pelvic tilt angle and C7 sagittal balance were significantly lower than those of the control group(P<0.05);there was no difference in thoracolumbar joint angle,lumbar kyphosis angle and pelvic projection angle between the two groups after treatment(P>0.05).There was no difference in slippage angle,percentage of slippage and intervertebral space height between the t

关 键 词：后路减压 椎间植骨融合术 退变性腰椎滑脱症 脊柱 骨盆参数 

分 类 号：R686.1[医药卫生—骨科学]