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后路减压联合不同融合节段固定治疗退变性脊柱侧凸的临床研究 预览 被引量:5

Clinicall study posterior decompression combined with different fusion with segmental fixation for treatment of degenerative scoliosis
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摘要 目的比较后路减压联合短节段融合与长节段融合治疗退变性脊柱侧凸的临床疗效。方法回顾性分析50例采用后路减压联合椎弓根钉固定融合治疗的退变性脊柱侧凸患者,按融合范围分为短节段组(28例)和长节段组(22例)。收集患者术前、术后1周影像学指标(侧凸Cobb角、Cobb角矫正率)、ODI评分以及并发症发生率。结果短节段组融合节段2.4个(1~3个),长节段组5.7个(4~7个),两组之间差异有统计学意义(P〈0.05)。术前短节段组侧凸Cobb角为(21.4±3.7)°,术后(13.6±214)。,矫正率36.4%;长节段组术前(32.9+6.2)。,术后(11.3+3.5)。,矫正率65.7%,两组手术前后差异均有统计学意义,且两组侧凸Cobb角纠正率之间差异有统计学意义。短节段组6例发生并发症,长节段组10例发生并发症,长节段组术后并发症发生率较短节段组高。两组患者ODI评分差异无统计学意义。结论后路加压联合椎弓根螺钉固定融合治疗退变性脊柱侧凸疗效肯定;侧凸Cobb角较小、脊柱平衡保持较好者可以选择短节段融合,侧凸严重甚至侧方严重滑脱者宜选用长节段融合。 Objective To comparie of posterior decompression combined with short-segment fusion with long segment fusion for treatment of degenerative scoliosis clinical curative effect. Methods A retrospective analysis of 50 cases with poste- rior decompression and pediele screw fixation for fusion in the treatment of degenerative scoliosis patients, according to the fu- sion range is divided into short segment group (28 cases) and long segment group (22 cases). Collection of patients preopera- tion, 1 week postoperative imaging indexes (Cobb, Cobb scoliosis angle angle correction rate), ODI score and the incidence of complications. Results Short segment of group fusion Section 2.4 (1-3), long segment group 5.7 (4-7), the difference be- tween the two groups was statistically significant (P〈0.05). The Cobb angle of short segment group:preoperative was (21.4± 3.7)°, postoperative (13.6±2.4)°, correction rate was 36.4%. Long segment group:pre-operation (32.9±6.2)°, postoperative (11.3±3.5)°, the correct rate of 65.7% ,before and after operation there were statistically significant differences in the two groups. Scoliosis Cobb angle correcting rate had significant difference between. Short segment group 6 cases with complications and long group 113 cases had complications,the postoperative complication rate of long segment group was higher than short segment group. 2 groups of patients before and after operation there was no significant difference in ODI scores. Conculsion The clin- ical effect of posterior compression joint pedicle screw fixation fusion for treatment of degenerative scoliosis was affirmation, sco- liosis Cobb angle was smaller, spinal balance keeping better can choose short-segment fusion, scoliosis serious even side of se- vere spondylolisthesis should choose long segmental fusion.
作者 周新强 汪代东 彭军 赵有春 Zhou Xinqiang, Wang Daidong, Peng Jun, et al. Department of orthopedics, the Shenzhen Baoan District Sharing People's Hospital, Guangdong 518104
出处 《中国现代医药杂志》 2013年第1期55-57,共3页 Modern Medicine Journal of China
关键词 脊柱侧凸 后路减压 椎弓根螺钉 融合节段 Degenerative scoliosis Posterior decompression Pedicle screw Fusion segment
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