老年退变性腰椎侧凸合并腰椎管狭窄症的手术疗效.doc

(老年退变性侧凸症卢旻鹏1 董靖邵高海1 李波1 余雨1 王群波1 焦春燕1（1. 重庆医科大学附属永川医院骨科；2. 重庆医科大学附属永川医院科；重庆 40） 【摘 要】 目的 退变性侧凸的临床疗效。方法 回顾性分析本院从2004年1月～200年1月收治的退变性侧凸患者37例。其中男性15例，女性22例，平均年龄为5.6±5.8岁，比较患者手术前后及末次随访时的Cobb角ODI 功能评分。结果 全部病例都获得了临床随访，平均随访时间18.5±月，术前O 功能评分平均.6±12.5分，平均.6±8.6分(P0.05)，末次随访时平均.3±6.8分(P0.05)；Cobb角由术前平均.3°±5.7°矫正至术后平均1.4°±6.3°，改善率平均为4.5％骨融合率达到100％无椎间融合器移位、椎间隙塌陷、断钉断棒等发生。结论 后路融合矫形术是治疗退变性侧凸的有效方法之一。 【关键词】Department of Orthopedics, Yongchuan Hospital, Chongqing Medical University, Chongqing 402160, China Corresponding author: SHAO Gao-hai,TelEmail: shaogaohai567@163.com 【Abstract】Objective To investigate clinical results of degenerative lumbar scoliosis assoiated with spinal stenosis of old patients. Methods From January 2004 to January 2008, 37 cases with degenerated scoliosis were treated with posterior long segment fixed and short-segment fusion technology. There were 15 males and 22 females, with the average age of (57.6±5.8) years. The clinical outcomes were evaluated by Cobb angle of curves and Oswestry Disability Index（ODI）of preoperative、postoperative and time of the final follow-up. Results All cases were follow-up, the mean follow-up period was (18.5±5.5) months. 87.8% of the patients who underwent thesymptoms and signs improved. The average ODI score was (59.6±12.5) points at the initial examination and (34.6±8.6) and (36.3±6.8) points at postoperative(P0.05) and the final follow-up respectively(P0.05). The average Cobbs angle was preoperative (25.3°±5.7°) and postoperative (11.4°±6.3°) with a mean correction rate of 84.5％. Bone fusion rate reached 100%o relevant complications such as vertebra fusion shift, the disc height the collapse, screw breakage broken happened. Conclusion Posterior long segment fixed and short-segment fusion was one of the effective ways of treatment to degenerative lumbar scoliosis. 【Key word】degenerative lumbar scoliosis; long segment; short-segment; fixed; fusion 退变性腰椎侧凸症（degenerative lumbar scoliosis，DLS）是指继发于严重的椎间盘退变、老年骨质疏松、多个节