摘要
目的对比长、短节段融合内固定治疗成人退变性脊柱侧凸的临床资料,为临床老人退变性脊柱侧凸方案选择提供参考。方法回顾性分析2013年4月至2015年4月110例老年退变性脊柱侧凸的患者的临床资料,根据所采用的手术方法不同分为长、短节段融合内固定治疗组,记录两组患者的性别、融合节段、手术时间、年龄、减压节段、术后住院时间、术中出血量以及整体平衡状态和Cobb's角,并比较两组晚期和早期并发症所占比率。结果两组患者的年龄、性别构成比、减压节段3个指标差异无统计学意义(P>0.05),长节段组患者的融合节段、出血量、手术时间、术后住院时间均明显高于短节段组(P<0.05),植入物密度低于短节段组(P<0.05)。长节段组患者的术前、术后、末次随访的Cobb's角均明显高于短节段组(P<0.05),术前、末次随访的冠状面平衡均高于短节段组患者(P<0.05),术前矢状面平衡明显高于短节段组(P<0.05),其它指标及时间段组间比较差异无统计学意义。短节段组患者并发症率明显低于长节段组患者,差异有统计学意义(P<0.05)。结论短节段融合内固定手术期容易出现侧凸进展、邻近节段退变等,但并发症发生率低;而长节段融合内固定手术手术时间长,能较好改善畸形,手术中出血量大,出现并发症的风险很高。
Objective To compare the long and short segment fusion fixation for the treatment of adult degenerative seoliosis complications, and provide a reference for the selection of clinical elderly degenerative scoliosis program. Methods Clinical data were retrospectively analyzed from April 2013 to April 2015, 110 cases of senile degenerative scoliosis patients, according to the different operation methods, were divided into long and short segment fusion fixation group. Gender, fusion segments, operation time, age, segment of decompression, postoperative hospitalization time, the amount of intraoperative bleeding and the overall balance and Cobb＇s angle in the two groups were collected and compared. The advanced and early complications in proportion of the two groups were compared. Results There was no significant difference in the two groups in age, sex ratio, decompression segment 3 index difference （ P 〉 0. 05 ） , long segment fusion group segment, bleeding volume, operation time, postoperative hospitalization time were significantly higher than those of the control group （ P 〈 0.05 ）, implant density （ lower than the control group P 〈 0.05 ）. Long segment of patients before and after operation and last follow - up Cobb＇s angle was significantly higher than that of short segment group （ P 〈 0. 05 ）. The coronal balance of long segment group before operation, at the end of the follow - up were higher than those of short segment group （ P 〈 0.05 ）, preoperative sagittal balance was significantly higher than that of the control group （ P 〈 0. 05 ）, the differences of other indexes and time between the two groups were not significant. Short segment groups with complications was significantly lower than that of the long segment group, the difference was statistically significant （ P 〈 0. 05 ）. Conclusion Two kinds of short segment fusion fixation period prone to scoliosis progression, but with lower complication rate and the degeneration of adjacent segments ; and the time of long segment fusion fixation surgery is long, can improve the deformity with large amount of bleeding in the operation and high risk of complications.
出处
《临床和实验医学杂志》
2016年第22期2215-2217,共3页
Journal of Clinical and Experimental Medicine
基金
国家卫生计生委医药卫生科技发展中心(编号:W2015QJ109)
关键词
退变性脊柱侧凸
长节段融合内固定
短节段融合内固定
Degenerative scoliosis
Long section of two kinds of fusion and internal fixation
Short section of two kinds of fusion and internal fixation
