摘要
目的:探讨脊髓内移术联合脊柱后路矫形内固定术对脊柱角状侧后凸畸形患者的神经功能的改善作用。方法:回顾性分析19例行脊髓内移术联合脊柱后路矫形内固定术治疗的脊柱角状侧后凸畸形患者病例资料,术后随访1年,拍摄站立位全脊柱正侧位X线片、全脊柱CT和MRI检查,测量冠状面主弯Cobb角、后凸Cobb角,并观察手术前后波幅及潜伏期变化、神经功能Frankel分级及生活质量改善情况,并记录并发症情况。结果:19例患者术后均完成1年随访,术后1个月、术后3个月、术后6个月及术后1年神经功能Frankel分级差异有统计学意义(P<0.05),随访1个月时均恢复至E级;术后冠状面主弯Cobb角及后突面主弯Cobb角度均显著减小,差异有统计学意义(P<0.05)。术后1周波幅明显上升,潜伏期显著下降,和术前及术中比较,差异有统计学意义(P<0.05)。术后6个月疼痛、心理状况、自我形象、功能状况及生活质量总评分显著较术前提高,差异有统计学意义(P<0.05)。此外,19例患者术后均未出现瘫痪、死亡及内固定松动及假关节形成等并发症。结论:脊髓内移术联合脊柱后路矫形内固定术治疗脊柱角状侧后凸畸形患者可有效改善患者神经功能,矫正脊柱畸形,提高患者术后生活质量,且安全性高。
Objective To explore the improvement of nerve function in spinal cord transplantation combined with posterior spinal orthopedic fixation on spinal kyphoscoliosis patients.Method A retrospective analysis was performed on 19 cases of spinal cord transplantation combined with posterior spinal orthopedic fixation on spinal kyphoscoliosis patients in our hospital,1 year follow up,shooting X-rays of standing position complete spinal lateral view,inspecting full spine CT and MRI,measuring coronal plane Cobb angle and convex Cobb angle to observe the amplitude and latency changes,Frankel grading of neurological function and the improvement of life quality before and after surgery,and recorded the complications.Results All 19 cases were followed up for 1 year after surgery,and there were significantly differences in Frankel grading of neurological function among 1 month after surgery,3 months after surgery,6 months after surgery and 1year after surgery(P<0.05),and all were recovered to grade E 1 month after surgery.The coronal plane Cobb angle and posterior curvature Cobb angle decreased significantly after surgery,and the difference was statistically significant(P<0.05).1 week after surgery,the amplitude was obviously increased,and the latency decreased significantly,and there was a significantly difference among preoperative and intraoperative(P<0.05).6 months after surgery,the overall scores of pain,psychological status,self-image,function status and life quality were significantly improved than those before surgery,and the differences were significant(P<0.05).In addition,complications such as paralysis,death,loosening of the internal fixation and formation of fake joint were found in 19 cases.Conclusion Spinal cord transplantation combined with posterior spinal orthopedic fixation on spinal kyphoscoliosis patients can effectively correct the spinal deformity,improve the neurological function and life quality after surgery,and is safer.
作者
王磊
WANG Lei(Department of orthopedics,Anhui Cancer Hospital,Hefei 230031,China)
出处
《吉林医学》
CAS
2019年第12期2732-2734,共3页
Jilin Medical Journal
