摘要
目的:探讨治疗退行性脊柱侧凸的手术策略,评价使用侧弯全节段椎弓根螺钉固定的疗效.方法:对我院骨科1998年7月～2003年7月手术治疗的82例退行性脊柱侧凸患者进行回顾性分析,41例行后路减压、椎体间cage置入、椎弓根螺钉矫形内固定+后外侧植骨融合术;14例行后路椎小关节截骨、减压、椎弓根螺钉矫形内固定+后外侧植骨融合术;10例行椎管减压、椎弓根螺钉矫形内固定+后外侧植骨融合术;17例先行一期前路脊柱松解、二期后路多节段椎弓根螺钉矫形,后外侧植骨融合.结果:手术均顺利完成,无死亡病例,围手术期切口感染1例,延迟愈合4例,7例术后出现呼吸道症状,经对症处理后好转;6例围手术期内出现心脏病复发,经过内科会诊处理平稳缓解.随访6个月～4年,影像学检查无断钉断棒,未见上、下融合椎部位的继发性脊柱后凸畸形.2年以上随访者42例,Oswetry功能评分由术前58.62±12.48分改善至31.15±14.12分.结论:在充分减压的前提下,侧弯全节段椎弓根螺钉技术可达到矫形、固定、融合、重建脊柱稳定性的目的,有利于退行性脊柱侧凸患者改善症状.
Objective: To investigate the surgical strategy for degenerative scoliosis and evaluate the clinical results of posterior pedicle screws correction technique.Method:82 patients had been operated on since July 1998 to July 2003.41 patients had one-stage posterior pedicle screws instrumentation correction,and PLIF intervetebra combined with posterlateral fusion.14 cases had posterior shortening and pedicle screws system correction with posterlateral bone grafting.10 cases only had posterior decompression and pedicle screws fixation with posterlateral bone grafting.17 cases with first anterior spinal release,structural grafting,staged posterior correction with pedicle screws system and posterlateral bone grafting.Result:No death was noted,1 cases with wound infection during perioperation period,4 cases delayed healing.Medical complication including 7 cases pneumonia,and 6 cases heart diseases recurrence.In this group,patients were followed up from 6 months to 4 years,there were no screw or rod breakase and no secondary scoliosis at upper or lower fused vertebral bodies as well.42 cases finished 2 years follow-up,Oswestry score improved from 58.62±12.48 before operation to 31.15±14.12 in 2 years follow-up.Conclusion:Segmental pedicle screws instruments shows good results for degenerative scoliosis correction,and can achieve satisfactory outcomes for low back pain relief and improvement of radicular syndrome and neurogenic claudication.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2005年第4期218-221,共4页
Chinese Journal of Spine and Spinal Cord
