[经后路减压融合内固定治疗退行性腰椎侧凸]

[Treatment of degenerative lumbar scoliosis via posterior decompression and fusion with internal fixation].

作者信息

Xie Yue, Xu Yong-yi, Wang Shou-guo, Ji Feng, Fei Hao-dong, Zhao Qing-hua, Tian Ji-wei

机构信息

Department of Orthopedics, Nanjing Medical University, Huai'an, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2011 Nov 8;91(41):2931-4.

PMID:22333617

Abstract

OBJECTIVE

To explore the pathogenic mechanism, operative techniques and therapeutic efficacy of lumbar degenerative scoliosis.

METHODS

A retrospective analysis was performed for 32 patients (14 males and 18 females with a mean age of 67.4 years old) with degenerative lumbar scoliosis undergoing posterior decompression and fusion with pedicle screw system from January 2007 to March 2010. The post-operative outcomes were radiologically evaluated with Oswestry disability index (ODI), Cobb' angle and lumbar lordosis angle.

RESULTS

All patients received a mean follow-up of 28.5 months (range: 12 - 50). All lumbar joints achieved bony fusion at Month 6 post-operation. No complications occurred due to instrumentation. There was no pseudoarthrosis. The significant differences of ODI existed between pre-operation and post-operation [(60 ± 11)% vs (21 ± 6)%, P < 0.01], Cobb' angle [(28 ± 9)° vs (13 ± 5)°, P < 0.01] and lumbar lordosis angle [(41 ± 12)° vs (20 ± 10)°, P < 0.01].

CONCLUSION

Individualized operations should be performed for degenerative lumbar scoliosis patients. Proper lumbar decompression and the reconstruction of coronal and sagittal balances may relieve symptoms and improve the quality of life.

摘要

目的

探讨腰椎退变性侧凸的发病机制、手术技巧及治疗效果。

方法

对2007年1月至2010年3月间32例（男14例，女18例，平均年龄67.4岁）接受后路减压及椎弓根螺钉系统融合术治疗的退变性腰椎侧凸患者进行回顾性分析。采用Oswestry功能障碍指数（ODI）、Cobb角和腰椎前凸角对术后结果进行影像学评估。

结果

所有患者平均随访28.5个月（范围：12 - 50个月）。所有腰椎节段均在术后6个月实现骨性融合。未发生与内固定相关的并发症。无假关节形成。术前与术后ODI[（60±11）%对（21±6）%，P<0.01]、Cobb角[（28±9）°对（13±5）°，P<0.01]及腰椎前凸角[（41±12）°对（20±10）°，P<0.01]比较差异均有统计学意义。