经后路责任节段减压、长节段矫形固定融合治疗退变性腰椎侧凸

发布时间：2018-03-13 18:35

本文选题：退变性腰椎侧凸　切入点：长节段　出处：《郑州大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的探讨经后路责任节段减压、长节段矫形固定融合治疗退变性腰椎侧凸的中期疗效。材料与方法回顾性分析2008年6月至2011年9月郑州大学第一附属医院骨科诊治的33例退变性腰椎侧凸患者的临床资料。33例患者均采用经后路责任节段减压、长节段矫形固定融合治疗,对患者术前、术后3个月和末次随访的视觉模拟量表(VAS)评分、日本矫形外科协会(JOA)评分、冠状面Cobb角、矢状面腰椎前凸角、冠状面及矢状面稳定性进行对比,评估疗效。结果所有患者均获得随访,平均随访时间5.2±1.1年。术前患者JOA评分为12.8±3.4分,VAS评分为7.6±1.9分,冠状面Cobb角39.4±11.6°,矢状面腰椎前凸角17.6±10.3°,冠状位失衡2.8±1.1cm,矢状位失衡4.4±2.6cm,术后3个月的JOA评分为24.1±2.8分,VAS评分为1.8±0.7分,冠状面Cobb角14.5±5.4°,矢状面腰椎前凸角30.2±12.5°,冠状位失衡0.9±0.6cm,矢状位失衡2.5±1.6cm,末次随访的JOA评分为22.8±3.6分,VAS评分为2.1±1.5分,冠状面Cobb角14.1±5.8°,矢状面腰椎前凸角29.4±10.8°,冠状位失衡0.9±0.4cm,矢状位失衡2.1±1.3cm。术前与术后3个月、末次随访比较均得到改善,差异有统计学意义(P0.05)。术后3个月与末次随访比较,差异无统计学意义(P0.05)。末次随访发现VAS评分、JOA评分、矢状面腰椎前凸角效果轻度丢失,腰部轴性疼痛加重3例,轻度下肢麻木4例。结论经后路责任节段减压、长节段矫形固定融合是治疗冠状面Cobb角30°、冠状面和矢状面失衡的DLS的一种有效方法。
[Abstract]:Objective to explore the posterior decompression of responsible segments. Long segment orthopedic fusion for the treatment of degenerative lumbar scoliosis. Materials and methods A retrospective analysis of 33 cases of degenerative lumbar scoliosis treated by orthopaedic department of the first affiliated Hospital of Zhengzhou University from June 2008 to September 2011. Clinical data. 33 patients were treated with posterior decompression. The visual analogue scale (VAS) score, the Japanese Orthopaedic Surgical Association (JOAA) score, the coronal Cobb angle, the sagittal lumbar spine kyphosis angle, the preoperative, the postoperative 3 months and the last follow-up visual analogue scale (VAS) scores, coronal Cobb angle, sagittal lumbar spine kyphosis angle, were evaluated. Results all the patients were followed up with an average follow-up time of 5.2 卤1.1 years, and the preoperative JOA score was 12.8 卤3.4 and 7.6 卤1.9, respectively. The coronal Cobb angle was 39.4 卤11.6 掳, the sagittal lumbar kyphosis angle was 17.6 卤10.3 掳, the coronal imbalance was 2.8 卤1.1 cm, the sagittal imbalance was 4.4 卤2.6 cm, and the JOA score was 24.1 卤2.8 min. The coronal Cobb angle was 14.5 卤5.4 掳, the sagittal lumbar kyphosis angle was 30.2 卤12.5 掳, the coronal imbalance was 0.9 卤0.6 cm, and the sagittal imbalance was 2.5 卤1.6 cm. The JOA score of the last follow-up was 22.8 卤3.6 and 2.1 卤1.5 respectively. The coronal Cobb angle was 14.1 卤5.8 掳, the sagittal lumbar kyphosis angle was 29.4 卤10.8 掳, the coronal imbalance was 0.9 卤0.4 cm, and the sagittal imbalance was 2.1 卤1.3 cm. There was no significant difference between the two groups (P 0.05). At the last follow-up, VAS score was found to be slightly lost in sagittal lumbar spine kyphosis, 3 cases with lumbar axial pain and 4 cases with mild lower extremity numbness. Conclusion there are 4 cases of lower extremity numbness and 3 cases of lumbar spinal kyphosis in sagittal plane. Long segment orthopedic fusion is an effective method for the treatment of DLS with coronal Cobb angle 30 掳, coronal and sagittal disequilibrium.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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