| 摘要: |
| 目的：评价个体化手术治疗退变性腰椎侧凸合并腰椎管狭窄症的临床疗效。方法：回顾性分析自 2013 年 5 月—2017 年 5 月陆军军医大学大坪医院采用个体化手术，治疗 48 例重度退变性腰椎侧凸合并腰椎管狭窄症的临床疗效，即：根据每例患者的症状、体征、影像学表现，判定责任节段，精准减压；根据侧凸的类型应用截骨矫正、钉棒矫正、融合器矫正等方法适度矫正；合理应用长节段融合。观察术后疼痛缓解和功能改善情况。结果：所有患者均顺利完成手术，平均随访 29.5 月，术后患者临床症状明显缓解或消失，术后患者的 Cobb 角显著减小（P<0.01）、腰椎前凸角显著恢复（P<0.01），VAS 评分显著降低（P<0.01），ODI 评分显著改善（P<0.01）；未出现严重并发症。结论：个体化手术是治疗重度退变性腰椎侧凸合并腰椎管狭窄症的有效方法之一。 |
| 关键词: 腰椎 退变性侧凸 椎管狭窄 减压 融合术 |
| DOI：10.3969/j.issn.1007-6948.2019.06.039 |
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| 基金项目: |
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| Individualized Surgery in Treatment of Severe Degenerative Lumbar Scoliosis with Stenosis |
| ZHANG Xiao-xing,ZHU Jun |
| Department of Orthopedics, the Fourth People' s Hospital of Chongqing, Chongqing (400014), China |
| Abstract: |
| Objective To evaluate the clinical effect of individualized surgery in the treatment of degenerative lumbar scoliosis with stenosis. Methods From May 2013 to May 2017，48 patients with severe degenerative lumbar scoliosis with stenosis were treated by individualized surgery. The symptoms, signs, imaging performance of each patient, determination of the responsibility segment and accurate decompression were observed. According to the type of lateral convex, the method of osteotomy correction, nail rod correction, cage correction and so on should be corrected moderately, and the long segment fusion should be applied rationally. The postoperative pain relief and functional improvement were observed. Results All surgeries were successfully implemented, the average follow-up time was 29.5 months, all patients’ clinical symptoms of postoperative were significantly alleviated or disappeared, the postoperative Cobb angle significantly decreased (P<0.01), the postoperative lumbar anterior convex angle significantly recovered (P<0.01), the postoperative VAS score significantly decreased (P<0.01), and the postoperative ODI score significantly improved (P<0.01). There were no serious complications. Conclusion Individualized surgery is one of the effective methods for the treatment of severe degenerative lumbar scoliosis with stenosis. |
| Key words: Lumbar vertebrae degenerative scoliosis spinal stenosis decompression fusion |
