| 卫宝宁,刘 伟,赵奋伟,刘 鹏,宋文慧,赵 胜,张 晶,马 燕,刘烈东.自体髂骨移植用于后路椎弓根钉棒系统矫形内固定术治疗脊柱侧凸的临床效果及对预后的影响[J].,2019,19(17):3330-3333 |
| 自体髂骨移植用于后路椎弓根钉棒系统矫形内固定术治疗脊柱侧凸的临床效果及对预后的影响 |
| Effect of Autogenous Iliac Bone Graft for the Posterior Pedicle Screw Rod System Orthopedic Internal Fixation for Scoliosis |
| 投稿时间：2019-01-20 修订日期：2019-02-16 |
| DOI：10.13241/j.cnki.pmb.2019.17.027 |
| 中文关键词: 后路椎弓根钉棒系统 自体骨移植 退行性脊柱侧凸 |
| 英文关键词: Posterior pedicle screw rod system Autogenous bone graft Degenerative scoliosis |
| 基金项目:陕西省自然科学基金项目(SJ08F32) |
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| 中文摘要: |
| 摘要 目的：探讨自体髂骨移植用于后路椎弓根钉棒系统矫形内固定术治疗脊柱侧凸的临床效果及对患者预后的影响。方法：选取2014年4月至2017年4月90例在我院及山西医科大学进行手术治疗的退行性脊柱侧凸患者作为研究对象，按照随机法将患者分为两组，各组45例患者。对照组采用后路椎弓根钉棒系统矫形内固定术，观察组采用后路椎弓根钉棒系统矫形内固定结合自体髂骨移植术。比较两组患者围手术期情况，术前、术后7天及术后12个月腰椎后凸角度、Cobb角、JOA评分、ODI评分的变化及术后并发症发生情况。结果：两组患者手术时间、术中出血量、体温恢复时间、WBC恢复正常时间、引流管置管时间比较差异无统计学意义(P>0.05)。两组患者术后腰椎前凸角度、Cobb角较手术前明显改善(P<0.05)；术后12个月，观察组患者腰椎前凸角度高于对照组，Cobb角显著低于对照组(P<0.05)。两组患者术后JOA评分高于手术前，ODI评分低于手术前(P<0.05)；观察组患者术后12个月JOA评分高于对照组，ODI评分低于对照组(P<0.05)。观察组患者并发症发生率显著低于对照组(P<0.05)。结论：自体髂骨移植应用于后路椎弓根钉棒系统矫形内固定术治疗退行性脊柱侧弯效果较好，不仅可纠正脊柱侧弯，同时可减轻患者疼痛感及不适感，安全性较高。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinical effect of autologous iliac bone transplantation for posterior pedicle screw-rod system internal fixation in the treatment of scoliosis and its influence on the prognosis of patients. Methods: From April 2014 to April 2017, 90 cases of patients with degenerative scoliosis who underwent surgical treatment in our hospital and Shanxi Medical University were selected as the study subjects. The patients were divided into two groups according to random method, with 45 patients in each group. The control group was treated with posterior pedicle screw-rod system, while the observation group was treated with posterior pedicle screw-rod system combined with autologous iliac bone transplantation. The changes of lumbar kyphosis angle, Cobb angle, JOA score, ODI score and complications were compared between the two groups before operation, at 7 days after operation and at 12 months after operation. Results: There was no significant difference in the operation time, blood loss, temperature recovery time, WBC recovery time and drainage tube indwelling time between the two groups (P>0.05). The lumbar lordosis angle and Cobb angle of both groups were significantly improved after operation (P<0.05); at 12 months after operation, the lumbar lordosis angle of observation group was higher than that of the control group, and the Cobb angle was significantly lower than that of the control group (P<0.05). The JOA score of both groups was higher than that before operation, and the ODI score was lower than that before operation (P<0.05); the JOA score of observation group was higher than that of the control group at 12 months after operation, and the ODI score was lower than that of the control group (P<0.05). The incidence of complications in the observation group was significantly lower than that in the control group (P<0.05). Conclusion: Autologous iliac bone transplantation is effective in the treatment of degenerative scoliosis with posterior pedicle screw-rod system. It can not only correct the scoliosis, but also alleviate the pain and discomfort with high safety. |
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