单纯减压手术有效改善腰椎管狭窄症脊柱矢状面的形态  

Impact of Decompression Surgery without Fusion for Lumbar Spinal Stenosis on Sagittal Spinopelvic Alignment

作　　者：聂克[1] 梁杰[2] 熊元[1] 茹能[2] 杨宗 张帆[2] 伍伟飞[2] 

机构地区：[1]湖北省枝江市人民医院,湖北枝江 [2]三峡大学人民医院,宜昌市第一人民医院,湖北宜昌

出　　处：《临床医学进展》2019年第2期110-115,共6页Advances in Clinical Medicine

基　　金：国家自然科学基金(编号:81702198).

摘　　要：目的:探讨退变性腰椎管狭窄单纯减压手术对术后临床症状的改善情况及脊柱矢状面形态的影响。材料与方法:分析我院84例退变性腰椎管狭窄患者,均行单纯椎管减压手术治疗,术前、末次随访均行全脊柱站立位X线检查。矢状面参数包括骨盆倾斜角(PT)、胸椎后凸角(TK)、腰椎前凸角(LL)、骶骨倾斜角(SS)、矢状面偏移(SVA)、骨盆入射角(PI)。两组间差异采用配对样本t检验。结果:相比术前,术后LL和TK显著增(P分别为0.024,0.011). SVA和PI-LL显著下降(P分别为0.027,0.004),PT、PI、SS和TLK手术前后无明显变化。术后数字评分法(NRS)分数相比术前均显著降低(P为0.007)。结论:单纯减压手术能有效改善退变性腰椎管狭窄患者的临床症状和恢复脊柱矢状面的形态。Objective: To evaluate radiographical changes in sagittal spinopelvic alignment and clinical symptoms after decompression surgery for lumbar spinal stenosis. Methods: We retrospectively reviewed 84 patients who underwent lumbar decompression without fusion. Standing whole-spine radiographs at the preoperative stage and at the final follow-up were examined. We analyzed sagittal vertical axis (SVA), lumbar lordosis (LL), pelvic tilt (PT), pelvic incidence (PI), thoracolumbar kyphosis (TLK), and thoracic kyphosis (TK). Results: LL and TK were significantly increased postoperatively. SVA, PI-LL and NRS were significantly decreased. There were no signif-icant differences between the preoperative and postoperative PT, PI, SS, or TLK. Conclusion: Lumbar decompression can lead to a reactive improvement in the lumbar and global sagittal alignment and can improve pre-operative symptoms.

关 键 词：退变性腰椎管狭窄 单纯减压手术 脊柱 矢状面形态 

分 类 号：R6[医药卫生—外科学]