【摘要】 目的探讨后路选择性减压、椎弓根螺钉内固定、椎体间植骨融合治疗退行性脊柱侧凸的手术方法及临床效果。方法回顾性分析我院骨科2005年8月至2012年6月,后路手术治疗32例退行性脊柱侧凸患者的病例资料。对患者术前及术后行Oswestry功能障碍指数评分、下腰痛JOA评分,并用JOA改善率评估手术疗效。结果32例患者均行后路手术治疗,手术均顺利完成,无死亡病例,术后平均随访3.4年,影像学检查无钉棒松动、断裂,无术后继发性脊柱侧凸畸形。Oswestry功能障碍指数评分术前、术后6个月、术后2年分别为:(61.35±15.68)分、(26.21±16.32)分、(22.32±9.58)分,差异有统计学意义(P<0.05);术前、术后6个月、术后2年JOA下腰痛评分为:(12.26±2.34)分、(15.28±2.32)分、(23.86±2.67)分,差异有统计学意义(P<0.05);JOA改善优良率达88.3%。结论选择性后路减压、椎间植骨融合、椎弓根螺钉固定、适当矫形重建脊柱平衡,有利于提高退行性脊柱侧凸患者生活质量,是治疗退变性腰椎侧凸的一种有效方法。更多还原

【Abstract】 Objective To investigate the surgical method of selective posterior decompression,pedicle screw fixation and interbody fusion in the treatment of degenerative scoliosis(DS) and the clinical results.Methods 32 patients with DS underwent posterior surgical treatment in our Department from August 2005 to June 2012,whose data were retrospectively analyzed.The Oswestry Disability Index(ODI) scores,Japanese Orthopedic Association(JOA) scores of low back pain and the improvement rate of JOA scores were used to evaluate the preoperative and postoperative results.Results 32 patients underwent posterior surgical treatment,which was successfully completed with no death.All patients were followed up for an average period of 3.4 years postoperatively.According to the imaging examination,no loosening,breakage or secondary scoliosis was found.The ODI scores were(61.35±15.68)points,(26.21±16.32) points and(22.32±9.58) points respectively before the operation and at 6 and 24 months after the operation,and the differences were statistically significant(P<0.05).The JOA scores of low back pain were(12.26±2.34) points,(15.28±2.32) points,(23.86±2.67) points before the operation and at 6 and 24 months after the operation,and the differences were statistically significant(P<0.05).The improvement rate of JOA scores was 88.3%.Conclusions The surgical method of selective posterior decompression,interbody fusion,pedicle screw fixation and reconstruction of the spinal balance after appropriate correction is effective in the treatment of DS,which can improve the life quality of patients with DS.更多还原