腰椎生理曲度变化与退变性腰椎滑脱症术后下腰痛相关性分析

发布时间：2018-03-22 09:53

本文选题：退变性腰椎滑脱症　切入点：腰椎融合　出处：《山西医科大学》2015年硕士论文　论文类型：学位论文

【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。
[Abstract]:Objective: to investigate and analyze the correlation between the changes of lumbar physiological curvature and lower back pain in degenerative lumbar spondylolisthesis patients after PLIF(posterior lumbar interbody infusion.Methods: from November 2012 to January 2014, we retrospectively analyzed the clinical data of patients with degenerative lumbar spondylolisthesis treated in orthopaedic department from November 2012 to January 2014. Clinical data of 43 patients with degenerative lumbar spondylolisthesis undergoing PLIF(posterior lumbar interbody fusion and postoperative low back pain, During a 12-month follow-up, 8 of the patients were not visited, while the remaining 35 patients (11 males and 24 females, with an average age of 62.4 years) were treated preoperatively and 6 months after surgery. After 12 months of operation, the lumbar vertebrae were taken to stand in positive position, and lateral X-ray film was taken to measure the Cobb angle in sagittal position of lumbar vertebrae. At the same time, the correlation between the changes of Cobb angle of lumbar vertebrae and the clinical curative effect was analyzed by statistical method. Results: the VAS(visual analogue scale score of 6 months after operation and 12 months after operation was compared with that before operation. There were very significant improvements in the ODI(Oswestry disability scores of t 2.2108g / g 2.099 脳 10 ~ (-3) and t 0.1682n / min ~ (3.610 脳 10 ~ (-04)) respectively. There were also significant changes in the scores of ODI(Oswestry disability at 6 months after operation and 12 months after operation. The scores of t _ (2.2411) P _ (0.02829) and t _ (2.7615) P _ (7.395) 脳 10 ~ (-03) were also significantly improved. There was no significant difference between preoperative and postoperative Cobb angles in sagittal position of lumbar vertebrae and 6, 12 months after operation. There was no significant difference between preoperative Cobb angle and postoperative Cobb angle (t = 0.0337P ~ (0.9732) and t ~ (-0.1607) P ~ (0.8728)). Lumbar kyphosis was positively correlated with VAS(visual analogue scale score and ODI(Oswestry disability index score in all patients 6 and 12 months after operation. Conclusion: patients with degenerative lumbar spondylolisthesis underwent posterior lumbar fusion after posterior lumbar fusion with 0.5685P0.0004 and 0.6512P0.0005P0.6055P0.0004.Conclusion: the patients with degenerative lumbar spondylolisthesis underwent posterior lumbar fusion. Lumbar pain is closely related to the change of Lumbar Lumbar kyphosis. Therefore, the reconstruction of lumbar lordosis during the operation has a positive effect on the postoperative clinical efficacy. Meanwhile, PLIF(posterior lumbar interbody fusion has a significant clinical effect in the treatment of degenerative lumbar spondylolisthesis.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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