摘要
目的:探讨退行性腰椎侧弯合并腰椎管狭窄的手术方法及其临床效果。方法:回顾性分析32例适应证患者经后路椎间融合器或后外侧融合结合椎弓根系统固定的治疗效果。男18例,女14例;年龄49～75岁,平均56.8岁;腰椎前凸基本未变者15例,腰椎侧弯伴有椎体半脱位和腰前凸丢失严重者17例。术后测量退变性脊柱侧弯的矫正效果、观察腰腿疼痛改善率、并发症和随访结果。结果:全部病例获得随访,时间6～49个月,平均13个月。术后平均侧弯矫正率为58.0%,疼痛改善率为(80.2±5.8)%(P<0.05),硬脊膜囊撕裂2例,神经根损伤2例,假关节形成1例。随访期间矫正度数、椎间隙高度无丢失,融合器无移位,内固定物融合良好,植骨融合率96.9%。结论:后路椎间融合器或后外侧融合结合经椎弓根系统是治疗退变性脊柱侧弯合并腰椎管狭窄的一种安全有效的方法。手术应重视矫正腰椎侧弯畸形、改善腰椎力学平衡,以提高术后中远期临床疗效。
Objective ：To study surgical techniques for degenerative lumbar scoliosis associated with lumbar stenosis and evaluate their clinical significane. Methods ：Thirty-two patients with degenerative lumbar scoliosis associated with spinal stenosis were treated by techniques of posterior lumbar interbody fusion or posterolateral fusion and pedicle screws. There were 18 male and 14 female with 56.8 years old on the average（ranging from 49 to 75 years）. There were no evident change of lumber lordosis in 15 eases, and lumber lordosis were obvious loss associated with lumbar subluxation in 17 cases. The correcting, the improvement of back and leg pain, complications and followed-up results were analyzed retrospectively. Results：Thirty-two eases were followed-up for 6 to 39 months （the average time of 13 months）. The average correction rate of scoliosis was 58.0% and the rate of pain relief was （80.2＋5.8）%. There were two cases of dura sac laceration, two eases of nerve roots injury and a ease of pseudoarthritis. During followed-up, correction rate and height of disc spaces were not lost. Shift of interbody cages were no displaced; all the internal fixation got well fusion and the rate of fusion for the bone graft was 96.9%. Conclusion： Posterior pediele screws combined with interbody fusion or posterolateral fusion is a safe and effective surgical treatment for degenerative lumbar scoliosis associated with lumbar stenosis.
出处
《中国骨伤》
CAS
2008年第11期860-862,共3页
China Journal of Orthopaedics and Traumatology
