摘要
目的:探讨椎弓根螺钉固定与选择性下腰椎椎间减压融合治疗退变性腰椎侧凸的临床疗效。方法:回顾分析退变性腰椎侧凸患者椎弓根螺钉固定与选择性下腰椎椎间减压融合术治疗122例,A组固定融合在L_5节段,B组固定融合在S_1节段,节段影像学分析及Suk标准评价固定、减压、植骨融合情况,JOA评分评价疗效。结果:两组患者手术时间、术中出血量、术后引流量差异均无显著性(P>0.05);122例均获得平均(16.2±0.8)个月随访;术后冠状面和矢状面Cobb′s角、侧凸矫正率和前凸矫正率均获得明显改善,B组的前凸矫正率优于A组(P<0.05);两组椎间融合率、JOA腰背痛评分及末次随访时患者的疗效优良率比较差异无显著性(P>0.05);术后无感染、螺钉断裂等不良事件;术后邻椎病发生率A组高于B组(P<0.05)。结论:椎弓根螺钉固定与选择性椎间减压融合治疗下腰椎退变性脊柱侧凸,中短期临床效果满意。
Objective To investigate clinical effect of local decompression and selective interbody fusionwith pedicle screw fixation technique for the treatment of degenerative lumbar scoliosis. Methods Medical recordsof 122 degenerative lumbar scoliosis patients were retrospectively studied. All cases were treated by selectiveinterbody fusion,local decompression and pedicle screw fixation. Group A（L_5fusion）and group B（S_1fusion）un-derwent imaging analysis,and Suk criteria was used to evaluate the fixation,decompression,bone graft fusion.JOA scores were used to evaluate curative effect of excellent and good rate. Results There were no significantdifference in operating time,blood loss and postoperative drainage volume between two groups. Follow-up period forall patients is（16.2 ± 0.8）months. X-ray revealed that Cobb′s angle on the coronal plane,the correction rate of lor-dosis and sagittal Cobb′s angle after treatment,the correction rate of lordosis in group B were better than in group A（P 〈0.05）. There were no significant differences in intervertebral fusion rate,low back pain score of JOA and theeffective rate at final follow-up between two groups（P 〉0.05）. There was no infection or screw breakage and pullingout. The incidence rate of adjacent vertebral body disease in group A was higher than that in group B（P 〈0.05）.Conclusions Local decompression and selective interbody fusion with pedicle screw fixation technique for the treat-ment of degenerative lumbar scoliosis can produce satisfactory short to mid-term clinical curative effect.
出处
《实用医学杂志》
CAS
北大核心
2017年第2期222-226,共5页
The Journal of Practical Medicine
基金
国家自然科学基金面上项目(编号:81172012)
关键词
椎弓根螺钉
椎间融合
腰椎
脊柱侧凸
退变
Pedicle screws
Lumbar interbody fusion
Lumbar vertebrae
Scoliosis
Degeneration
作者简介
通信作者：郑小飞E-mail：doctorzhengxiaofei@Hotmail．com
