Du Jianwei, Tang Xiangyu, Li Ningdao, Zhang Lin, Zhang Xifeng
Department of Orthopaedics, Chinese People's Liberation Army General Hospital (301 Hospital), 28 Fuxing Rd., Beijing, 100853, People's Republic of China.
Department of Orthopaedics, Yangzhou No.1 People's Hospital, 368 Hanjiang Rd., Yangzhou, 225001, People's Republic of China.
Int Orthop. 2016 Jun;40(6):1227-31. doi: 10.1007/s00264-016-3128-0. Epub 2016 Feb 24.
The aim of the study was to investigate the feasibility of limited long-segment fusion for a special kind of scoliosis: degenerative lower lumbar scoliosis without severe thoracolumbar kyphosis.
A total of 43 patients with degenerative lower lumbar scoliosis who underwent spinal surgery at our hospital from June 2003 to September 2012 were included in this retrospective study. The apical vertebrae included L3 and L4, the end vertebra was L2 or L3, and the T10-L2 kyphosis angle was <20°. The limited long-segment fusion group (upper end vertebrae L2) included 19 patients, and the long-segment fusion group (upper end vertebrae T9-11) included 24 patients. The radiographic parameters and Oswestry disability index (ODI) scores were compared between the two groups pre-operatively and at the last follow-up evaluation.
The differences in the lumbar Cobb angle, lumbar lordosis angle, pelvic tilt angle, sacral slope angle, T10-L2 kyphosis angle, proximal junctional kyphosis angle, and ODI scores between the two groups pre-operatively and at the last follow-up evaluation were not statistically significant (p > 0.05). The limited long-segment fusion group did not exhibit post-operative proximal junctional kyphosis.
Limited long-segment fusion is effective for patients with degenerative lower lumbar scoliosis without severe thoracolumbar kyphosis.
本研究旨在探讨有限长节段融合治疗一种特殊类型脊柱侧凸的可行性:无严重胸腰段后凸的退变性下腰椎脊柱侧凸。
本回顾性研究纳入了2003年6月至2012年9月在我院接受脊柱手术的43例退变性下腰椎脊柱侧凸患者。顶椎包括L3和L4,端椎为L2或L3,且T10-L2后凸角<20°。有限长节段融合组(上端椎为L2)包括19例患者,长节段融合组(上端椎为T9-11)包括24例患者。比较两组术前及末次随访时的影像学参数和Oswestry功能障碍指数(ODI)评分。
两组术前及末次随访时的腰椎Cobb角、腰椎前凸角、骨盆倾斜角、骶骨倾斜角、T10-L2后凸角、近端交界性后凸角及ODI评分差异无统计学意义(p>0.05)。有限长节段融合组未出现术后近端交界性后凸。
有限长节段融合对于无严重胸腰段后凸的退变性下腰椎脊柱侧凸患者有效。