【摘要】 目的探讨分析退行性脊柱侧凸畸形长节段融合选择不同远端融合椎并发症的临床疗效。方法选择在该院进行治疗的退行性脊柱侧凸畸形患者42例,选择时间为2018年3月—2019年3月,随机将患者分为常规组和实验组,两组患者均行长节段融合治疗,常规组L5为LIV,实验组S1为LIV,对两组患者的并发症情况及手术效果进行比较分析。结果常规组患者并发症发生率为9.52%(2例);实验组患者并发症发生率为28.10%(8例),常规组患者的并发症发生率较实验组更低,差异有统计学意义(χ~2=4.725,P=0.030)。术前及术后两组患者的Cobb角及冠状面偏移情况差异无统计学意义(t=0.561、0.040、0.821、1.083,P=0.578、0.969、0.417、0.434),但两组患者术后的Cobb角及冠状面偏移情况较术前更为优异,差异有统计学意义(t=7.191、8.238、17.518、17.458,P=0.000、0.000、0.000、0.000)。结论当LIV为L5或S1时,均能展现出较好的融合效果,对Cobb角及冠状面偏移情况进行显著的改善,但L5为LIV时引起的并发症更少,具有一定的治疗安全性,利于患者的预后恢复,值得临床推广使用。更多还原

【Abstract】 Objective To investigate the clinical efficacy of long-segment fusion of degenerative scoliosis with different distal fusion ver-tebral complications. Methods A total of 42 patients with degenerative scoliosis who underwent treatment in the hospital were selected.The patients were randomly divided into the conventional group and the experimental group from March 2018 to March 2019. Both groups had long segments. In the fusion therapy, the conventional group L5 was LIV, and the experimental group S1 was LIV. The complications and surgical results of the two groups were compared and analyzed. Results The complication rate of the routine group was 9.52%(2 cases). The complication rate of the experimental group was 28.10%(8 cases). The complication rate of the routine group was lower than that of the experimental group. The difference was statistically significant(χ~2=4.725, P=0.030). There were no significant differences in Cobb angle and coronal deviation between the two groups before and after surgery( t=0.561, 0.040, 0.821, 1.083,P=0.578, 0.969, 0.417, 0.434), but the two groups were postoperatively. The Cobb angle and coronal offset were superior to those be-fore surgery, and the difference was statistically significant(t=7.191, 8.238, 17.518, 17.458, P=0.000, 0.000, 0.000, 0.000). Conclusion When LIV is L5 or S1, it can show better fusion effect, significantly improve Cobb angle and coronal deviation, but L5 causes less complications and has certain treatment safety, which is conducive to the recovery of the patient’s prognosis, is worthy of clinical pro-motion.更多还原