CAJ | 학술논문

目的探讨腰椎退变性侧凸症的发病机制、手术方法和临床疗效.方法回顾性分析自2007年1月至2010年3月期间行腰椎后路减压植骨融合内固定术治疗的32例腰椎退变性侧凸症患者,其中男14例,女18例,年龄为52 ～79岁,平均67.4岁.通过比较术前、术后Oswestry功能障碍指数( ODI)、Cobb's角和腰椎前凸角变化来评价手术疗效.结果 32例均获得12～ 50个月的随访,平均随访28.5个月,所有患者均在6个月后获得骨性融合,椎弓根螺钉位置良好,无断钉断棒,无假关节形成现象.术前ODI为(60±11)％,术后末次随访时为(21±6)％；术前Cobb's角数为(28±9)°,术后末次随访时为(13±5)°；术前腰椎前凸角为(20±10)°,术后末次随访时为(41±12)°,差异均有统计学意义(均P＜0.05).结论腰椎退变性侧凸症手术治疗应采取个体化设计,必须减压得当同时恢复重建腰椎冠状面和矢状面平衡,才能缓解患者的腰腿痛症状,提高生活质量.
목적 탐토요추퇴변성측철증적발병궤제、수술방법화림상료효.방법 회고성분석자2007년1월지2010년3월기간행요추후로감압식골융합내고정술치료적32례요추퇴변성측철증환자,기중남14례,녀18례,년령위52 ～79세,평균67.4세.통과비교술전、술후Oswestry공능장애지수( ODI)、Cobb's각화요추전철각변화래평개수술료효.결과 32례균획득12～ 50개월적수방,평균수방28.5개월,소유환자균재6개월후획득골성융합,추궁근라정위치량호,무단정단봉,무가관절형성현상.술전ODI위(60±11)％,술후말차수방시위(21±6)％；술전Cobb's각수위(28±9)°,술후말차수방시위(13±5)°；술전요추전철각위(20±10)°,술후말차수방시위(41±12)°,차이균유통계학의의(균P＜0.05).결론 요추퇴변성측철증수술치료응채취개체화설계,필수감압득당동시회복중건요추관상면화시상면평형,재능완해환자적요퇴통증상,제고생활질량.
Objective To explore the pathogenic mechanism,operative techniques and therapeutic efficacy of lumbar degenerative scoliosis.Methods A retrospective analysis was performed for 32 patients ( 14 males and 18 females with a mean age of 67.4 years old) with degenerative lumbar scoliosis undergoing posterior decompression and fusion with pedicle screw system from January 2007 to March 2010.The postoperative outcomes were radiologically evaluated with Oswestry disability index (ODI),Cobb' angle and lumbar lordosis angle.Results All patients received a mean follow-up of 28.5 months ( range:12 - 50).All lumbar joints achieved bony fusion at Month 6 post-operation.No complications occurred due to instrumentation.There was no pseudoarthrosis.The significant differences of ODI existed between preoperation and post-operation[ (60 ± 11 )％ vs (21 ±6)％,P ＜0.01 ],Cobb' angle[ (28 ±9)° vs ( 13 ±5)°,P ＜ 0.01 ] and lumbar lordosis angle[(41 ± 12)° vs (20 ± 10)°,P ＜ 0.01 ].Conclusion Individualized operations should be performed for degenerative lumbar scoliosis patients.Proper lumbar decompression and the reconstruction of coronal and sagittal balances may relieve symptoms and improve the qualitv of life.