摘要
目的 探讨不同手术方式治疗退行性脊柱侧弯的临床效果。方法 回顾性分析1999年1月至2005年6月手术治疗的退行性脊柱侧弯40例。其中,男18例,女22例;年龄：51-74岁,平均62岁;40例患者被分为三组分别采用：单纯椎管减压;椎管减压术联合后路内固定融合;椎管减压术、椎间融合联合后路内固定融合。随访期间观察症状减轻优良率,侧弯的矫正效果,椎间融合情况及并发症。结果 随访6 -48个月,平均16个月,症状减轻优良率分别为：78.57%、75.00%、85.71%,三种手术方式术后症状减轻优良率差异无统计学意义（P〉0.05）。使用内固定的患者侧弯Cobb角度平均矫正率分别为：46.05%、47.87%,在随访期内纠正角度、椎间隙高度无丢失率分别为75.00%、85.71%;未使用内固定的患者侧弯角度未加大。结论 退行性脊柱侧弯的病变较复杂,手术方式的选择应根据侧弯程度、节段性椎管狭窄程度、锥体半脱位、锥体稳定情况以及是否存在骨质疏松等多种情况综合考虑。
Objective To discuss clinic effect of different operation to treat degenerative scoliosis. Methods The clinic data of 40 degenerative scoliosis patient during 1999 -2005. 18 males and 22 females, aged 62 （ 51 - 74）. They were divided into three groups, one group underwent pure depression, such as laminectomy or incision of intervertebral foramen; 2nd group underwent depression of vertebral canal and pure internal fixation and fusion of pedicle combined with correction of scoliosis ; 3rd group underwent posterior lumber interbody fusion with pedicle screws combined with correction .of scoliosis. During an average 16 months （6 -48 months） follow -up, the radio of symptom -lightened,the corrective effects of scoliosis, condition of intervertebral fusion, and complication were observed. Results During follow - up, three groups radio of symptom - lightened was 78.57%, 75.00% ,85.71% individually （ P 〉 0. 05）. Radio of scoliosis with pedicle screws was 46.05%, 47.87% individually; No loss radio in correction angle and height of disc space 75.00% ,85.71% individually ; Scoliosis angle of no fusion with pedicle screws hadn＇ t increase. Conclusion Pathological changes in degenerative scoliosis are very complex. Choice of operation must consider scoliosis degree, and segment vertebra canal straitness degree, and cone dislocation, and cone stabilization, and osteoporosis and so on.
出处
《医药论坛杂志》
2007年第6期18-20,42,共4页
Journal of Medical Forum
关键词
退行性
脊柱侧弯
疗效
脊柱融合术
Degeneration
Scoliosis
Curative effect
Spinal fusion
