后路微矫形术治疗退行性脊柱侧弯合并椎管狭窄的疗效  

The efficacy of posterior micro-deformity correction surgery in degenerative scoliosis with spinal stenosis

作　　者：陈家豪 范丽萍 毛炜彬 钱佳敏 陈哲 Chen Jiahao

机构地区：[1]浙江中医药大学第二临床医学院,310053 [2]浙江中医药大学附属第二医院,310005

出　　处：《浙江临床医学》2025年第2期193-196,共4页Zhejiang Clinical Medical Journal

基　　金：国家自然科学基金资助项目(81873128);浙江省中医药科技项目(2023ZL461)。

摘　　要：目的研究后路微矫形术对退行性脊柱侧弯合并椎管狭窄的患者在冠状位矫形的治疗效果。方法回顾性分析2017年1月至2023年7月期间在本院手术治疗的退行性脊柱侧弯合并椎管狭窄患者的资料,按手术方式分为微矫形组和融合内固定组。比较两组患者术前、术后不同时间点的各个指标,包括冠状位L1至S1上终板面夹角、手术节段相邻上位椎间盘冠状位终板面成角、冠状位骨盆倾斜角、椎间隙与椎体高度比值、CT灰度值等。结果共纳入91例患者,微矫形组46例,融合内固定组45例,两组患者在性别、年龄、手术节段数量上差异无统计学意义(P>0.05)。微矫形组在脊柱冠状位矫形和平衡效果,以及术后冠状位L1至S1上终板面夹角、冠状位骨盆倾斜角的维持方面,均明显优于融合内固定组(P<0.05)。从术后3个月开始,微矫形组在手术节段相邻上位椎间盘冠状位终板面成角上明显优于融合内固定组(P<0.05)。术后1年,微矫形组在维持椎间隙和椎体高度比值上优于融合内固定组(P<0.05)。两组在CT灰度值上的差异无统计学意义(P>0.05)。结论后路微矫形术在脊柱冠状位矫正和维持效果方面优于腰椎后路减压融合内固定术,有助于患者姿势调整和体态保持。Objective To investigate the therapeutic effect of posterior micro-deformity correction surgery on coronal plane deformity correction in patients with degenerative scoliosis complicated by spinal stenosis.Methods A retrospective analysis was conducted on the clinical data of patients with degenerative scoliosis complicated by spinal stenosis who underwent surgery at our hospital from January 2017 to July 2023.Patients were divided into two groups based on the surgical approach:the micro-correction group and the decompression fusion and internal fixation group.Various indicators were compared between the two groups at different time points before and after surgery,including the coronal angle of the superior endplate from L1 to S1,the coronal angle of the superior endplate of the intervertebral disc adjacent to the surgical segment,the coronal pelvic tilt angle,the ratio of intervertebral space to vertebral body height,and CT grayscale value,etc.Results A total of 91 patients were included in the study,with 46 in the micro-deformity correction group and 45 in the fusion and internal fixation group.There were no statistically significant differences in gender,age,or the number of surgical segments between the two groups(P>0.05).The micro-deformity correction group showed significantly better results in the correction and balance effects of the coronal plane of the spine,as well as in the maintenance of the coronal angle of the superior endplate from L1 to S1 and the coronal pelvic tilt angle after surgery compared to the fusion and internal fixation group(P<0.05).Starting from three months postoperatively,the micro-deformity correction group showed a significant advantage in the coronal angle of the superior endplate of the intervertebral disc adjacent to the surgical segment compared to the fusion and internal fixation group(P<0.05).After one year,the micro-deformity correction group was superior in maintaining the ratio of intervertebral space to vertebral body height compared to the fusion and internal fixation g

关 键 词：退行性脊柱侧弯 腰椎后路减压融合内固定术 后路微矫形术 脊柱冠状位平衡 椎管狭窄 

分 类 号：R687.3[医药卫生—骨科学]