选择性减压融合治疗伴退行性滑脱的多节段腰椎管狭窄症的效果观察  

Effect observation of selective decompression and fusion in the treatment of multiple segment lumbar spinal stenosis with degenerative spondylolisthesis

作　　者：张洪亮[1] 翁阳华[1] 黎佩珍[1] 伊莉[1] 陈丽言 李忠辉[1] ZHANG Hong-liang;WENG Yang-hua;LI Pei-zhen;YI Li;CHEN Li-yan;LI Zhong-hui(Department of Orthopedics,Dongguan Humen Hospital,Guangdong Province,Dongguan523902,China)

机构地区：[1]广东省东莞市虎门医院骨科,广东东莞523902

出　　处：《中国当代医药》2021年第12期95-97,共3页China Modern Medicine

基　　金：广东省东莞市社会科技发展项目(201650715001406)。

摘　　要：目的探讨选择性减压融合治疗伴退行性滑脱的多节段腰椎管狭窄症的临床效果。方法选取2009年4月~2019年4月东莞市虎门医院收治的80例多节段腰椎管狭窄症伴退行性滑脱患者作为研究对象,采用随机数字表法分为对照组(40例)与观察组(40例)。对照组采用多节段减压融合治疗方法,观察组采用选择性减压融合治疗方法。比较两组的手术时间、术中出血量、融合节段占比、腰腿疼痛视觉模拟评分(VAS)、日本矫形外科协会评分(JOA)、腰部功能障碍指数(ODI)。结果观察组手术时间短于对照组,差异有统计学意义(P<0.05);术中出血量少于对照组,差异有统计学意义(P<0.05);治疗前后两组腿痛VAS评分、腰痛VAS评分、JOA评分、ODI评分比较,差异无统计学意义(P>0.05);两组治疗后的腿痛VAS评分、腰痛VAS评分、ODI评分低于本组治疗前,JOA评分高于本组治疗前,差异有统计学意义(P<0.05);观察组融合节段占比低于对照组,差异有统计学意义(P<0.05)。结论选择性减压融合治疗伴退行性滑脱的多节段腰椎管狭窄症有一定的临床效果。Objective To explore the clinical effect of selective decompression and fusion in the treatment of multiple segment lumbar spinal stenosis with degenerative spondylolisthesis.Methods A total of 80 patients with multiple segment lumbar spinal stenosis with degenerative spondylolisthesis admitted to Dongguan Humen Hospital from April 2009 to April 2019 were selected as the research objects and divided into the control group(40 cases)and the observation group(40 cases)according to random number table method.The control group was treated with multiple segment decompression and fusion,and the observation group was treated with selective decompression and fusion.The operation time,intraoperative blood loss,proportion of fusion segments,visual analogue scale(VAS)for low back pain and leg pain,Japanese orthopedic association(JOA)score,and oswestry disability index(ODI)were compared between the two groups.Results The operation time of the observation group was shorter than that of the control group,and the difference was statistically significant(P<0.05).The intraoperative blood loss was less than that of the control group,the difference was statistically significant(P<0.05).There were no significant differences in the VAS scores of leg pain and low back pain,JOA score and ODI score bwtweem the two groups before and after treatment(P>0.05).The scores of leg pain VAS and low back pain,JOA score of the two group were lower than those before treatment,the ODI score of the two groups was higher than that before treatment,and the differences were statistically significant(P<0.05).The proportion of fusion segments in the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Selective decompression and fusion in the treatment of multiple segment lumbar spinal stenosis with degenerative spondylolisthesis has certain clinical effect.

关 键 词：选择性减压融合 退行性滑脱 多节段腰椎管狭窄症 疼痛视觉模拟评分 日本矫形外科协会评分 

分 类 号：R687.3[医药卫生—骨科学]