短节段减压融合内固定与Dynesys治疗Lenke-Silva Ⅱ级退行性脊柱侧凸症的疗效对比

发布时间：2018-08-10 20:35

【摘要】：[目的]比较短节段腰椎减压融合内固定术(PLIF)与动态固定系统(Dynesys)治疗退行性脊柱侧凸的围手术期并发症及临床疗效。[方法]回顾性分析本院2006~2015年所有的退变性腰椎侧弯矫形手术,病例纳入标准为Lenke-Silva Ⅱ级,根据采用的术式分为PLIF组33例,Dynesys组20例。其中男18例,女35例,平均年龄(57.3±6.9)岁(48~72岁)。固定2个节段的16例,3个节段的37例。分析术前与术后的腰椎侧凸Cobb角、VAS评分和ODI指数,以及手术时间、术中出血量、术后引流量等指标。两组之间使用独立样本t检验,置信区间为95%。[结果]PLIF组平均随访时间(28.2±14.9)个月,Dynesys组(29.2±12.0)个月。Dynesys组手术时间、术中出血量和术后引流量均少于PLIF组;PLIF组各种围手术期并发症发生率为33.33%,Dynesys组为20%。两组间差异有统计学意义(P0.05)。PLIF组和Dynesys组VAS评分改善率分别为82.81%、80.60%,ODI指数改善率分别为77.80%、78.95%,两组间差异无统计学意义(P0.05)。PLIF组和Dynesys组Cobb角矫形改善率分别为81.68%、74.78%,术后矫形丢失率分别为5.32%、18.34%,两组间差异有统计学意义(P0.05)。[结论]Dynesys组手术时间、出血量、引流量、围手术期并发症均少许PLIF组。临床症状改善率与PLIF组相当。但矫形效果和腰椎稳定性不及PLIF组。
[Abstract]:[objective] to compare the perioperative complications and clinical efficacy of short segment lumbar decompression fusion internal fixation (PLIF) and dynamic fixation system (Dynesys) in the treatment of degenerative scoliosis. [methods] all degenerative Lumbar Lumbar Lumbar degenerative Correction Orthosis in our hospital from 2006 to 2015 were analyzed retrospectively. The included cases were Lenke-Silva There were 18 males and 35 females with an average age of (57.3 卤6.9) years (4872 years). 16 cases of 2 segments and 37 cases of 3 segments were fixed. To analyze the Cobb score and ODI index of lumbar scoliosis before and after operation, as well as the time of operation, the amount of blood lost during operation and the drainage flow after operation. An independent sample t test was used between the two groups, with a confidence interval of 95. [results] the average follow-up time in PLIF group was (28.2 卤14.9) months. The operative time, intraoperative blood loss and postoperative drainage volume in Dynesys group were (29.2 卤12.0) months, which were less than those in PLIF group. The incidence of perioperative complications in PLIF group was 33.33 卤12.0 months. There was significant difference between the two groups (P0.05). The improvement rate of VAS score in PLIF group and Dynesys group was 82.81 and 80.60, respectively. The improvement rate of ODI index was 77.80 and 78.95, respectively. There was no significant difference between the two groups (P0.05). The improvement rate of Cobb angle correction in PLIF group and Dynesys group was 81.68% and 74.78, respectively. The difference between the two groups was statistically significant (P0.05). [conclusion] in Dynesys group, the operation time, blood loss, drainage flow and perioperative complications were few in PLIF group. The improvement rate of clinical symptoms was similar to that of PLIF group. But the orthopedic effect and stability of lumbar vertebrae were not as good as those in PLIF group.
【作者单位】：华中科技大学同济医学院附属普爱医院骨科;
【分类号】：R687.3

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