【摘要】 目的探讨两种后路减压固定融合术治疗退变性腰椎侧凸(DLS)的手术效果。方法选取我院2014年2月至2016年4月手术治疗的88例DLS患者进行回顾性分析,其中44例患者采用长节段后路减压固定融合术治疗(长节段组)、44例患者采用短节段后路减压固定融合术治疗(短节段组),对比两组患者的手术时间、手术出血量、手术减压节段数目、固定节段数、手术前后不同时间的腰椎侧凸Cobb角、腰椎前凸角、JOA评分、骨性融合率。结果长节段组患者的手术时间、手术出血量、固定节段数均显著的大于短节段组,差异有统计学意义(P<0. 05),长节段组患者的手术减压节段数目与短节段组差异无统计学意义(P>0. 05)。术前,两组患者的腰椎侧凸Cobb角、腰椎前凸角、JOA评分差异无统计学意义(P>0. 05);术后,长节段组患者的腰椎侧凸Cobb角低于短节段组,差异有统计学意义(P<0. 05),长节段组患者的腰椎前凸角、JOA评分与短节段组差异无统计学意义(P>0. 05);术后6个月、12个月,长节段组患者的植骨融合率与短节段组差异无统计学意义(P>0. 05);术后12个月,长节段组神经功能改善效果与短节段组比较,差异无统计学意义(P>0. 05)。结论在需要实施相同减压节段的情况下,DLS患者采用长节段后路减压固定融合术较短节段后路减压固定融合术能更好的改善术后Cobb角、固定节段数目更多,但是手术创伤较大,对患者的手术耐受力具有一定的要求。更多还原

【Abstract】 Objective To evaluate the surgical outcomes of two kinds of posterior decompression fixation fusion for treatment of degenerative lumbar scoliosis( DLS). Methods A retrospective analysis of 88 patients with DLS who underwent surgery from February 2014 to April 2016 was performed that 44 patients underwent long-segment posterior decompression fixation fusion( long segment group) and 44 patients were treated with short-segment posterior decompression fixation fusion( short segment group).The operation time,the amount of surgical bleeding,the number of surgical decompression segments,the number of fixed segments,the lumbar vertebrae lateral curvature Cobb angle and lordosis angle before and after surgery,JOA score and bone fusion rate were compared between two groups.Results The operation time,the amount of surgical bleeding and the number of fixed segments in the long-segment group were significantly higher than those in the short-segment group( P<0. 05).There was no significant difference in the number of surgical decompression segments between the long segment group and the short segment group( P >0. 05).Before operation,there were no significant difference in the lumbar vertebrae lateral curvature Cobb angle and lordosis angle and JOA score between two groups( P>0. 05).After operation,the long-segment group had lower lumbar vertebrae lateral curvature Cobb angle than short segment group with significant difference( P<0. 05).There was no significant difference in the lumbar vertebrae lordosis angle and JOA score( P>0. 05).At 6 and 12 months after operation,there was no significant difference in the rate of bone graft fusion between two groups( P>0. 05).And the improvement of neurological function between two groups has no statistical significance at 12 months after surgery( P > 0. 05). Conclusion When the same segment is needed to be decompressed,the long-segment posterior decompression fixation fusion is better than the short-segment posterior decompression fixation fusion to improve the postoperative Cobb angle and the number of fixed segments for DLS patients.However,patient’s surgical tolerance is certainly requited because the surgical trauma is greater.更多还原