后路减压内固定融合术治疗退变性腰椎侧凸39例分析

发布时间：2019-05-13 12:41

【摘要】：[目的]探讨后路减压内固定融合术治疗退变性腰椎侧凸的临床效果。[方法]回顾性分析本院2013年10月~2015年4月接诊的39例退变性腰椎侧凸患者。均给予后路椎管减压并固定融合术治疗,术后随访1年。观察术后腰椎JOA评分、视觉模拟评分(VAS)、影像学指标(Cobb角、腰椎前凸角、冠状面平衡、矢状面平衡)改善情况,并采用SRS-22标准对患者身体状况进行评估。观察术后并发症情况。[结果]经过手术治疗,患者腰椎侧凸症状得到明显改善。术后JOA评分显著增大(P0.05),且术后1年JOA评分显著高于术后半年和术前JOA评分(P0.05);术后VAS评分显著降低(P0.05),且术后1年VAS评分显著低于术后半年和术前VAS评分(P0.05);术后患者Cobb角、冠状面平衡、矢状面平衡显著降低(P0.05),且术后1年Cobb角、冠状面平衡、矢状面平衡显著低于术后半年和术前(P0.05);而术后腰椎前凸角显著增大(P0.05),且术后1年的腰椎前凸角显著高于术后半年和术前(P0.05);术后SRS-22评分良好。2例患者切口感染、3例硬脊膜破裂。[结论]后路椎管减压并固定融合术能明显缓解退变性腰椎侧凸的临床症状,无严重并发症,对退变性腰椎侧凸有明显的矫正效果。
[Abstract]:Objective to investigate the clinical effect of posterior decompression and internal fixation fusion in the treatment of degenerative lumbar scoliosis. [methods] from October 2013 to April 2015, 39 patients with degenerative lumbar spondylolisthesis were analyzed retrospectively. the results showed that 39 patients with degenerative lumbar scoliosis were diagnosed in our hospital from October 2013 to April 2015. All patients were treated with posterior spinal canal decompression and fixed fusion, and followed up for 1 year. The improvement of lumbar JOA score and visual simulation score (Cobb angle, lumbar protruding angle, coronal balance, sagittal balance) were observed, and the physical condition of the patients was evaluated by SRS-22 standard. The postoperative complications were observed. [results] after surgical treatment, the symptoms of lumbar scoliosis were significantly improved. The JOA score increased significantly after operation (P 0.05), and the JOA score 1 year after operation was significantly higher than that 6 months after operation and before operation JOA score (P 0.05). The VAS score decreased significantly after operation (P 0.05), and the VAS score 1 year after operation was significantly lower than that 6 months after operation and before operation VAS score (P 0.05). The Cobb angle, coronal balance and sagittal balance were significantly decreased (P 0.05), and the Cobb angle, coronal balance and sagittal balance 1 year after operation were significantly lower than those 6 months after operation and before operation (P 0.05). The lumbar protruding angle increased significantly after operation (P 0.05), and the lumbar kyphosis angle 1 year after operation was significantly higher than that 6 months after operation and before operation (P 0.05). The postoperative SRS-22 score was good. 2 patients with incision infection and 3 patients with dural rupture. [conclusion] posterior spinal canal decompression and fixation and fusion can obviously alleviate the clinical symptoms of degenerative lumbar scoliosis without serious complications, and has obvious correction effect on degenerative lumbar scoliosis.
【作者单位】：河南省南阳市中心医院骨二科;
【分类号】：R687.3

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