CAJ | 학술논문

目的总结退行性脊柱侧弯临床特征,探讨其手术适应症、手术方式选择、技巧及临床效果,以提高临床治疗水平.方法回顾性分析我科2005年2月-2009年2月住院手术治疗的27例退行性脊柱侧弯的临床资料.结果 27例患者中有6例行单纯后路减压,21例行椎板切除+椎管减压+椎弓根钉内固定+关节突植骨融合或部分椎体间植骨融合及横突间植骨融合术;术后患者的症状体征得到了明显改善,腰背疼痛改善率77.8%,间歇性跛行改善率92.5%,术后影像学改善率74.1%.结论对有手术适应症的退行性腰椎侧弯患者,应综合每一例患者的具体症状、体征、病变节段、椎管狭窄情况、腰椎失稳状态、椎体旋转程度以及全身状况,制定合理的治疗方案,以提高手术治疗的长期疗效.
목적 총결퇴행성척주측만림상특정,탐토기수술괄응증、수술방식선택、기교급림상효과,이제고림상치료수평.방법 회고성분석아과2005년2월-2009년2월주원수술치료적27례퇴행성척주측만적림상자료.결과 27례환자중유6례행단순후로감압,21례행추판절제+추관감압+추궁근정내고정+관절돌식골융합혹부분추체간식골융합급횡돌간식골융합술;술후환자적증상체정득도료명현개선,요배동통개선솔77.8%,간헐성파행개선솔92.5%,술후영상학개선솔74.1%.결론대유수술괄응증적퇴행성요추측만환자,응종합매일례환자적구체증상、체정、병변절단、추관협착정황、요추실은상태、추체선전정도이급전신상황,제정합리적치료방안,이제고수술치료적장기료효.
Objective To summarize the clinical features of lumbar degenerative scoliosis (LDS) and to explore the indications for surgery, selection of the surgical procedures, and the surgical efficacy in order to improve the clinical treatment level. Methods The clinical data on 27 patients who had undergone surgical treatment during the period of February 2005 to February 2009 were retrospectively analyzed. Results Of 27 patients, 6 received simple posterior decompression, the remaining 21 received resection of lamina of vertebral arch combined with spinal canal decompression, internal fixation of pedicle of vertebral arch, and articular process bone graft fusion or partial intervertebral bone graft fusion or transverse process fusion. The symptoms and signs were improved obviously in all the patients.Low back pain relieved in 77.8% of the patients, relieved in 92.5% of the patients, and the radiologic findings were improved in 74.1% of the patients. Conclusions For the patients with LDS who are surgical candidates, logical treatments should be established based on the specific symptoms and signs, the affected portion of the vertebral column, the stricture level of the spinal canal, the unstable state of lumbar vertebrae, the vertebral rotation degree, and the general physical condition, so that the long-term efficacy of surgery can be improved.