【作者】 张志敏；

【导师】 霍建忠；

【作者基本信息】 山西医科大学 ， 外科学（专业学位）， 2015， 硕士

【摘要】 目的:探讨并分析退变性腰椎滑脱症患者在经过PLIF(posterior lumbar interbody infusion)术后其下腰痛与腰椎生理曲度变化的相关性。方法:回顾性分析我院于2012年11月-2014年1月由骨科收治的43例接受腰椎PLIF(posterior lumbar interbody infusion)术的退变性腰椎滑脱症并且术后出现下腰痛的患者临床资料,进行为期12个月的随访,在随访的患者中其中8名患者失访,其余35名患者(男11人,女24人),平均年龄为62.4岁。对患者术前、术后6个月、术后12个月患者的腰椎进行站立位正位、侧位X线片,测量其腰椎矢状位Cobb角,同时通过统计学方法分析腰椎Cobb角的变化与患者术后临床疗效的相关性。结果:手术后6个月与手术后12个月的VAS(visual analogue scale)评分与手术前相比,有非常明显的改善(t=3.2108,P=2.099×10-03及t=0.1682,P=3.610×10-04);同时患者术后6个月与术后12个月的ODI(Oswestry disability index)评分也有显著的改变(t=2.2411,P=0.02829及t=2.7615,P=7.395×10-03);术前腰椎矢状位Cobb角与术后6、12个月比较差别无统计学意义(t=-0.0337,P=0.9732及t=-0.1607,P=0.8728);术后6个月及术后12个月所有患者的腰椎前凸改变与VAS(visual analogue scale)评分及ODI(Oswestry disability index)评分均呈正相关(r=0.6235P=0.0005,r=0.5685 P=0.0004及r=0.6512 P=0.0005,r=0.6055 P=0.0004)。结论:退变性腰椎滑脱症患者接受后路腰椎融合术后其下腰痛与腰椎前凸的改变关系紧密,因此手术过程中腰椎前凸的重建对术后临床疗效有着积极的作用。同时PLIF(posterior lumbar interbody infusion)术治疗退变性腰椎滑脱症患者其临床疗效显著。更多还原

【Abstract】 Objective:Study of the relationship between Clinical Outcome and the loss of lumbar lordosis in the Surgical Treatment of degenerative lumbar spondylolisthesis.Methods:retrospective analysis was carried out in the clinical data of 35 patients who accepted PLIF and who came to our hospital from November 2012 to January 2014.Eight of these patients were lost to follow-up.The rest of the 35 patients(11 male, 24 female) average age was 62.4years old.Anterioposterior and lateral radiography of standing lumbar spine was taken during the follow-up and the lumbar lordosis Cobb angles were measured on radiography.At the same time through the statistical methods to analysis between lumbar cobb angle of the change and clinical curative effect.Results:VAS and ODI at 6 months and 12 months after the surgery was statisticallybetter than that before the surgery; loss of lumbar sagittal lordosis was positively correlated with VAS and ODI 6 months and 12 months after operation.Conclusions:Loss of lumbar sagittal lordosis is closely related with low back pain in patients accepted.PLIF And lumbar lordosis reconstruction during surgery is important.At the same time PLIF technique in the treatment of degenerative lumbar spondylolisthesis with the clinical curative effect is remarkable.更多还原