| 张培根 衡孝来 吴文涛 解迪 瞿科斌.后路减压内固定融合矫形治疗退变性腰椎侧凸伴椎管狭窄的临床研究[J].,2016,16(16):3138-3141 |
| 后路减压内固定融合矫形治疗退变性腰椎侧凸伴椎管狭窄的临床研究 |
| Posterior Decompression and Internal Fixation and Orthopedic Fusion forDegenerative Lumbar Scoliosis with Spinal Canal stenosis |
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| DOI： |
| 中文关键词: 退变性腰椎侧凸 椎管狭窄 后路矫形 |
| 英文关键词: Degenerative lumbar scoliosis Spinal canal stenosis Posterior spinal |
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| 中文摘要: |
| 目的：探讨后路减压内固定融合矫形治疗退变性腰椎侧凸伴椎管狭窄的临床疗效。方法：将我院2009 年1 月~2015 年1 月
收治的退变性腰椎侧凸伴椎管狭窄患者按照手术方法分为两组，实验组进行后路减压内固定融合矫形术治疗，对照组进行单纯
后路减压固定矫形术治疗，对比两组患者术前、术后6 个月和18 个月的Cobb 角、腰椎前凸角、日本骨科学会( JOA) 评分、疼痛视
觉模拟量表(VAS)情况，SRS-22 国际标准量表评分情况以及出血量情况。结果：实验组术后18 个月的Cobb 角、腰椎前凸角分别
为（16.8± 5.16）° 和（36.8± 5.82）° ，均分别低于对照组的（20.2± 6.61）° 和（41.2± 5.67）° ，且均低于术前（P<0.05），而术前及术
后6 个月时两组比较无差异（P>0.05）；两组患者术后6 个月和18 个月的JOA 评分、VAS 评分比较均较术前明显改善（P<0.05），
且组间比较显示，术后18 月两组比较均存在显著差异（P<0.05）；SRS-22 国际标准评估量表显示，术后18 个月两组患者的自理能
力、自我评价、精神状态方面无显著差异（P>0.05），而疼痛情况存在显著差异（P<0.05）。两组术中出血量比较无统计学差异（P>0.
05）。结论：后路减压内固定融合矫形术治疗退变性腰椎侧凸伴椎管狭窄疗效显著，且后路减压内固定融合矫形术在改善患者的
腰椎侧凸程度、功能障碍及疼痛程度方面优于单纯后路减压矫形内固定术，值得临床推广。 |
| 英文摘要: |
| Objective:To investigate the clinical efficacy of posterior decompression and internal fixation and orthopedic fusion
for the treatment of degenerative lumbar scoliosis with spinal canal stenosis.Methods:The patients with degenerative lumbar scoliosis
with spinal stenosis, who were treated in Mianyang 404 hospital of Sichuan /Second Affiliated Hospital of North Sichuan Medical
College from January 2009 to January 2015, were divided into two groups according to the operation method. The experimental group
was treated with posterior decompression and internal fixation and orthopedic fusion; the control group was treated with simple posterior
decompression and fixation. The Cobb angle, lumbar lordosis angle, japanese orthopaedic association (JOA) score, visual analogue scale
(VAS), scoliosis research society 22 (SRS-22) international standard scale and intraoperative blood loss in the two groups before
operation, 6 months and 18 months after operation were compared.Results:The Cobb angle and lumbar lordosis angle of experimental
group were (16.8± 5.16)° and (36.8± 5.82)° respectively, which were lower than (20.2+6.61)° and (41.2+5.67)° of control group
18 months after operation and before operation (P<0.05). But there were no significance between the two groups before operation and 6
months after operation (P>0.05). The JOA scores and VAS scores of two groups 6 months and 18 months after operation were improved
significantly than before operation (P<0.05). There were significant differences between the two groups 18 months after operation(P<0.
05). SRS-22 international standard scale showed that the self-care ability, self evaluation,mental state of patients in the two groups had no
significance 18 months after operation (P>0.05), while the pain showed significant difference (P<0.05). The intraoperative blood loss of
patients in the two groups had no significance(P>0.05).Conclusion:The clinical efficacy of posterior decompression and internal fixation
and orthopedic fusion in the treatment of patients with degenerative lumbar scoliosis with spinal canal stenosis is remarkable, and it is
superior to simple posterior decompression and internal fixation in improving the degree of scoliosis, dysfunction and pain of patients,
which is worthy of clinical application. |
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