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退行性腰椎侧凸的动态稳定矫正的临床和放射学结果(使用刚性棒);并描述一种替代技术。

Clinical and radiological outcomes after correction of degenerative lumbar scoliosis with dynamic stabilization (with the help of a rigid rod); and describing an alternative technique.

机构信息

Okan University, Department of Neurosurgery, Istanbul, Turkey.

Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey.

出版信息

J Clin Neurosci. 2020 Sep;79:123-128. doi: 10.1016/j.jocn.2020.07.023. Epub 2020 Aug 5.

Abstract

Sharing clinical and radiological results in patients with degenerative lumbar scoliosis (DLS) treated surgically with dynamic system and describing an alternative technique for scoliosis correction. Between 2013 and 2018, 48 patients with flexible degenerative lumbar scoliosis (DLS) were operated with dynamic stabilization with Polyetheretherketone Rod (PEEK rod) after rigid rod application. Preoperative and postoperative scoliosis angles (standing and supine) were statistically compared. Preoperative and postoperative low back pain (LBP) Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores were compared. In addition, preoperative C7 Sagittal Vertical Axis (SVA) values and lumbar lordosis angles were compared with postoperative values. The mean follow-up period of the patients was 48.3 months (range 30-76), the mean age was 67.08 (range 49-84). While the average Cobb angle of all patients was 9.65 in preoperative supine position, the average Cobb angle with standing position was 19.73. The mean standing Cobb angle of the patients after surgery was 3.52. The mean Cobb angle in the supine position after surgery was 3.02. The difference between the preoperative and postoperative patients' Cobb angles in standing and supine position were statistically significant (p:0,000, p:0,000, respectively). The differences of VAS and ODI scores between preoperative and postoperative period were statistically significantly (p:0,000, p:0,000; respectively). Especially in patients with flexible LDS, the technique we have defined and dynamic stabilization with PEEK rod provides significant correction. There was no loss of correction in our patients during postoperative follow-up period. PEEK rod is insufficient for lordosis increase and correction of SVA values.

摘要

在接受动态系统手术治疗的退行性腰椎侧凸(DLS)患者中分享临床和影像学结果,并描述一种用于矫正脊柱侧凸的替代技术。在 2013 年至 2018 年间,对 48 例具有柔韧性退行性腰椎侧凸(DLS)的患者进行了动态稳定治疗,在使用刚性棒后,使用聚醚醚酮棒(PEEK 棒)进行治疗。对术前和术后脊柱侧凸角度(站立位和仰卧位)进行了统计学比较。比较了术前和术后腰痛(LBP)视觉模拟量表(VAS)和 Oswestry 残疾指数(ODI)评分。此外,还比较了术前 C7 矢状垂直轴(SVA)值和腰椎前凸角与术后值。患者的平均随访时间为 48.3 个月(范围 30-76),平均年龄为 67.08 岁(范围 49-84)。虽然所有患者术前仰卧位的平均 Cobb 角为 9.65,但站立位的平均 Cobb 角为 19.73。术后患者的平均站立 Cobb 角为 3.52。术后仰卧位的平均 Cobb 角为 3.02。术前和术后患者站立和仰卧位的 Cobb 角差异有统计学意义(p:0.000,p:0.000)。VAS 和 ODI 评分在术前和术后的差异有统计学意义(p:0.000,p:0.000)。特别是在具有柔韧性 LDS 的患者中,我们定义的技术和 PEEK 棒的动态稳定提供了显著的矫正。在术后随访期间,我们的患者没有出现矫正丢失。PEEK 棒对于增加前凸和矫正 SVA 值是不够的。

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