摘要
背景:研究认为单纯椎管减压治疗退行性腰椎侧凸并椎管狭窄难以获得长期疗效,因为单纯减压被视为一种医源性的腰椎失稳,从而加重腰椎畸形。目的:分析腰后路减压、矫形固定、融合治疗退行性腰椎侧凸并椎管狭窄,随访矫正角度评价。方法:退行性腰椎侧凸并椎管狭窄患者23例均采用腰后路减压、矫形固定、融合治疗。采用症状目测类比评估表、Oswestry功能障碍指数评分表、SF-36调查问卷、腰椎冠状位Cobb角对患者治疗前和末次随访时生活质量变化情况及矫正角度进行评价。结果与结论:患者随访均超过6个月。Cobb角治疗前平均(23.94±11.4)°,治疗后平均(10.28±6.93)°;治疗后末次随访患者平均目测类比评分显著低于治疗前(P<0.05);治疗后末次随访Oswestry功能障碍指数评分显著低于治疗前(P<0.05),Oswestry功能障碍指数评分改善优良率为83.33%;治疗后SF-36调查问卷中的8个维度分值均较治疗前明显提高(P<0.05)。随访期间矫正角度无明显丢失,融合器无移位,内固定无断裂,植骨融合率100%。
BACKGROUND：Simple vertebral canal decompression for degenerative lumbar scoliosis with stenosis cannot obtain long-period curative effects. Simple decompression is considered aiatrogenic destabilization of lumbar vertebra, and aggravates lumbar malformation. OBJECTIVE：To analyze the effectiveness of posterior decompression, fixation and fusion in the treatment of degenerative lumbar scoliosis with stenosis and to evaluate corrective angle during half-year fol ow-up. METHODS：A total of 23 cases of degenerative lumbar scoliosis with stenosis underwent posterior decompression, fixation and fusion. Visual Analogue Scale, Oswestry disability index, 36-Item Short-Form Health Survey scale and the Cobb angle on the lumbar coronal film were used to assess the changes in quality of life and corrective angle before treatment and during final fol ow-up. RESULTS AND CONCLUSION：Al patients were fol owed up for at least 6 mouths. Mean Cobb angles were （23.94±177;11.4）° pretreatment and （10.28±177;6.93）° posttreatment. Mean Visual Analogue Scale scores were significantly lower posttreatment than pretreatment （P〈0.05）. Oswestry disability index scores were significantly lower posttreatment than pretreatment （P〈0.05）. The excellent and good rate of Oswestry disability index score was 83.33%. The eight scaled scores of 36-Item Short-Form Health Survey scale were significantly higher posttreatment than pretreatment （P〈0.05）. During half-year fol ow-up, there was no obvious loss in corrective angle. Shift of interbody cages was not displaced. No internal fixator breakage appeared. The rate of fusion for bone graft was 100%.
出处
《中国组织工程研究》
CAS
CSCD
2014年第17期2728-2733,共6页
Chinese Journal of Tissue Engineering Research
