后路经椎体间截骨治疗胸腰段退行性变三联征回顾性分析path between vertebral body bone cutting treatment thoracic lumbar segment degeneration views were retrospectively analyzed.pdfVIP

4.椎管侵占指标与 JOA 评分的相关性：考虑到个体差异性，本实验应用椎管相对 横径DS ′、椎管相对矢状径DS ′、椎管相对面积S ′，分别同JOA 评分行相关 2 1 1 性分析，经SPSS 16.0 分析，其相关系数依次是：R=0、P=0.0607 ；R=0， P=0.0295 ；R=0、P=0.0002 ；DS ′与JOA 无线性相关，DS ′、S ′与JOA 有线 2 1 1 性正相关且S ′相关性明显强于DS ′。 1 1 5.并发症：其中一例术后 6 个月随访发现椎弓根螺钉拔出，后凸角丢失，一例术 后发生脑脊液漏，采用低位硬膜外导管蛛网膜下腔脑脊液引流，完全治愈后出院， 其它患者随访未见并发症。 结 论： 1.胸腰段退行性变三联征是胸腰段的椎间盘突出/椎管狭窄伴后凸畸形，及节段性 不稳所致的以顽固性腰背疼痛、迟发性神经功能障碍为主的临床综合症。 2.患者的临床表现与受压脊髓椎管横截面积成正相关，可以认为受压脊髓椎管横 截面积能反映患者病情严重程度。 3.手术后Cobb 角立即得到矫正，随访一年以上后凸无明显增大，术后随访融合节 段稳定。 4.手术后椎管横直径、椎管横截面积明显增大，MRI 示脊髓压迫完全解除，后路经 椎体间截骨能达到很好的椎管减压效果。 5.手术后改良Frankel 分级、JOA 评分和SF-36 评分明显提高，脊髓损伤恢复佳， 功能改善明显，生活质量改善明显，患者满意度高。 6.过以上结果判定后路经椎体间截骨对三联征患者是可行的、有效的及安全的， 可以为临床此术式治疗三联征患者提供理论依据。 关键词：胸腰段 椎管狭窄 椎间盘突出 后凸畸形 不稳 - 2 - Abstract Objective : To evaluate the clinical effects of the treatment of thoracolumbar degenerative triad treated (TDT) with posterior interbody osteotomy （PIO ）through retrospective study ，and explore the safety and validity of the surgery. Methods: Fifteens of the 18 patients with thoracolumbar degenerative triad who were treated in the affiliated Hospital of Bengbu Medical College were retrospectively reviewed, including 8 males, 7 females. The age 17-55 years old, the average age is 46, All patients examined with X-ray and MRI before and after surgery. 1. Measure sagittal diameter of the spinal canal DS1, transverse diameter of the spinal canal DS2, cross-sectional area of the spinal canal S1 in MRI Axial-chip, Then compared pre-operative and post-operative changes in transverse, sagittal diameter and cro