椎弓根螺钉内固定联合腰椎后路椎间融合治疗高龄退行性腰椎滑脱症
发布时间：2019-05-18 08:50
【摘要】：背景:目前关于滑脱椎体是否需要复位临床存在一定争议。目的:观察椎弓根螺钉内固定联合腰椎后路椎间融合(PLIF)治疗70岁以上高龄退行性腰椎滑脱症患者的手术疗效。方法:回顾性分析30例70岁以上高龄退行性腰椎滑脱症患者采用腰椎后路椎弓根内固定术、减压联合椎体间融合治疗的临床资料。对内固定前后的疼痛目测类比评分,Oswestry功能障碍指数(ODI)和日本骨科学会(JOA)腰椎评分进行比较分析。结果与结论:(1)30例患者男12例,女18例,平均年龄为(75.1±6.7)岁。所有患者均顺利完成手术,随访时间均在12个月以上;(2)内固定后目测类比评分为显著优于内固定前(P0.05);内固定后ODI指数与腰椎JOA评分较内固定前有明显改善(P0.05);腰椎JOA评分改善率情况:治愈3例,显著有效24例,有效3例,无效0例;(3)根据椎间融合判定标准,所有患者均达到骨性融合,平均融合时间为(5.13±0.65)个月(4-8个月);(4)平均手术时间(225.6±23.4)min,平均术中出血量(470±45.5)mL。平均随访时间为(25.8±3.5)个月;(5)手术相关并发症共有6例(20%),其中1例硬膜囊撕裂,2例麻痹性肠梗阻,3例一过性下肢神经症状加重;(6)结果说明,在积极控制全身伴发疾病的基础上,椎弓根螺钉内固定联合椎体间融合治疗高龄退行性腰椎滑脱可取得良好的手术效果。
[Abstract]:Background: at present, there is some controversy about whether spondylolisthesis needs to be reduced clinically. Objective: to observe the surgical effect of pedicle screw fixation combined with posterior lumbar intervertebral fusion (PLIF) in the treatment of degenerative lumbar spondylolisthesis over 70 years old. Methods: the clinical data of 30 patients over 70 years old with degenerative lumbar spondylolisthesis treated with posterior pedicle internal fixation of lumbar vertebrae and decompression combined with interbody fusion were analyzed retrospectively. the clinical data of 30 patients with degenerative lumbar spondylolisthesis over 70 years old were analyzed retrospectively. The pain visual analogy score, Oswestry dysfunction index (ODI) and (JOA) lumbar vertebrae score before and after internal fixation were compared and analyzed. Results and conclusion: (1) there were 12 males and 18 females with an average age of (75.1 卤6.7) years. All the patients completed the operation successfully and the follow-up time was more than 12 months. (2) the visual analogy score after internal fixation was significantly better than that before internal fixation (P 0.05). The ODI index and lumbar JOA score after internal fixation were significantly improved compared with those before internal fixation (P 0.05), and the improvement rate of lumbar JOA score was cured in 3 cases, significantly effective in 24 cases, effective in 3 cases and ineffective in 0 cases. (3) according to the criteria of intervertebral fusion, all patients reached bone fusion, and the average fusion time was (5.13 卤0.65) months (4 鈮，
本文编号：2479860
[Abstract]:Background: at present, there is some controversy about whether spondylolisthesis needs to be reduced clinically. Objective: to observe the surgical effect of pedicle screw fixation combined with posterior lumbar intervertebral fusion (PLIF) in the treatment of degenerative lumbar spondylolisthesis over 70 years old. Methods: the clinical data of 30 patients over 70 years old with degenerative lumbar spondylolisthesis treated with posterior pedicle internal fixation of lumbar vertebrae and decompression combined with interbody fusion were analyzed retrospectively. the clinical data of 30 patients with degenerative lumbar spondylolisthesis over 70 years old were analyzed retrospectively. The pain visual analogy score, Oswestry dysfunction index (ODI) and (JOA) lumbar vertebrae score before and after internal fixation were compared and analyzed. Results and conclusion: (1) there were 12 males and 18 females with an average age of (75.1 卤6.7) years. All the patients completed the operation successfully and the follow-up time was more than 12 months. (2) the visual analogy score after internal fixation was significantly better than that before internal fixation (P 0.05). The ODI index and lumbar JOA score after internal fixation were significantly improved compared with those before internal fixation (P 0.05), and the improvement rate of lumbar JOA score was cured in 3 cases, significantly effective in 24 cases, effective in 3 cases and ineffective in 0 cases. (3) according to the criteria of intervertebral fusion, all patients reached bone fusion, and the average fusion time was (5.13 卤0.65) months (4 鈮，
本文编号：2479860
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