椎弓根螺钉固定局部减压与选择性椎间融合修复退变性腰椎侧凸.doc

椎弓根螺钉固定局部减压与选择性椎间融合修复退变性腰椎侧凸 李 丹1，罗 旭1，杨 俊2 (1武警湖南省总队医院，湖南省长沙市 410000；2解放军第四二一医院，广东省广州市 510318) 引用本文：李丹，罗旭，杨俊. 椎弓根螺钉固定局部减压与选择性椎间融合修复退变性腰椎侧凸[J].中国组织工程研究，2016，20(39):5807-5812. DOI: 10.3969/j.issn.2095-4344.2016.39.005 ORCID: 0000-0003-1523-4750(李丹) 文章快速阅读： 文题释义： 退变性脊柱侧凸：指骨骼发育成熟后，因脊柱的退行性变而出现的脊柱侧凸，退变性腰椎侧凸多见于中、老年人，随着人体进入中老年衰退期而伴随着进行性非对称性椎间盘和关节突关节退变从而导致的脊柱代偿性或失代偿性侧凸畸形，其中以退变性胸腰段、腰段脊柱侧凸最为常见。 退变性腰椎侧凸：腰椎退变性病变导致的腰椎冠状位10°以上但小于40°的成38个月随访，术后X射线提示，治疗后冠状面Cobb’s角(3.8±2.1)°，侧凸矫正率为54%；治疗后矢状面Cobb’s角(6.3±10.5)°，前凸矫正率为35%。Suk标准评定椎间融合率为95%；根据日本骨科学会腰背痛评分评估末次随访时患者的疗效优良率为91%；③术中硬膜囊破裂引发脑脊液漏2例，神经损伤1例，椎弓根螺Local decompression and selective interbody fusion with pedicle screw fixation technique for the treatment of degenerative lumbar scoliosis Li Dan1, Luo Xu1, Yang Jun2 (1Armed Police Corps Hospital of Hunan Province, Changsha 410000, Hunan Province, China; 2the 421 Hospital of PLA, Guangzhou 510318, Guangdong Province, China) Abstract BACKGROUND: Conservative treatment is mostly invalid in treatment of severe degenerative lumbar scoliosis-induced low back pain, so surgical intervention is generally required. Repair methods are decompression, rigid fixation, and selective interbody fusion for the “responsible vertebra” to re-establish normal lumbar curvature, spinal balance and good stability. OBJECTIVE: To investigate clinical curative effect of local decompression and selective interbody fusion with pedicle screw fixation technique for the treatment of degenerative lumbar scoliosis. METHODS: Data of 57 cases of degenerative lumbar scoliosis from Armed Police Corps Hospital of Hunan Province from January 2011 to January 2014 were retrospectively analyzed. According to clinical characteristics of the patients, selective fusion, local decompression and pedicle screw fixation were used for repair. The imaging analysis and Suk criteria were used to evaluate fixation, decompression and bone fusion. Japanese Orthopaedic Association scores were utilized to assess therapeutic effec