CAJ | 학술논문

背景：研究认为单纯椎管减压治疗退行性腰椎侧凸并椎管狭窄难以获得长期疗效，因为单纯减压被视为一种医源性的腰椎失稳，从而加重腰椎畸形。 　　目的：分析腰后路减压、矫形固定、融合治疗退行性腰椎侧凸并椎管狭窄，半年随访矫正角度评价。 　　方法：退行性腰椎侧凸并椎管狭窄患者23例均采用腰后路减压、矫形固定、融合治疗。采用症状目测类比评估表、Oswestry功能障碍指数评分表、SF-36调查问卷、腰椎冠状位Cobb角对患者治疗前和末次随访时生活质量变化情况及矫正角度进行评价。 　　结果与结论：患者随访均超过6个月。Cobb 角治疗前平均(23.94±11.4)°，治疗后平均(10.28±6.93)°；治疗后末次随访患者平均目测类比评分显著低于治疗前(P <0.05)；治疗后末次随访Oswestry功能障碍指数评分显著低于治疗前(P<0.05)，Oswestry功能障碍指数评分改善优良率为83.33%；治疗后SF-36调查问卷中的8个维度分值均较治疗前明显提高(P<0.05)。半年随访期间矫正角度无明显丢失，融合器无移位，内固定无断裂，植骨融合率100%。
배경：연구인위단순추관감압치료퇴행성요추측철병추관협착난이획득장기료효，인위단순감압피시위일충의원성적요추실은，종이가중요추기형。 　　목적：분석요후로감압、교형고정、융합치료퇴행성요추측철병추관협착，반년수방교정각도평개。 　　방법：퇴행성요추측철병추관협착환자23례균채용요후로감압、교형고정、융합치료。채용증상목측류비평고표、Oswestry공능장애지수평분표、SF-36조사문권、요추관상위Cobb각대환자치료전화말차수방시생활질량변화정황급교정각도진행평개。 　　결과여결론：환자수방균초과6개월。Cobb 각치료전평균(23.94±11.4)°，치료후평균(10.28±6.93)°；치료후말차수방환자평균목측류비평분현저저우치료전(P <0.05)；치료후말차수방Oswestry공능장애지수평분현저저우치료전(P<0.05)，Oswestry공능장애지수평분개선우량솔위83.33%；치료후SF-36조사문권중적8개유도분치균교치료전명현제고(P<0.05)。반년수방기간교정각도무명현주실，융합기무이위，내고정무단렬，식골융합솔100%。
BACKGROUND:Simple vertebral canal decompression for degenerative lumbar scoliosis with stenosis cannot obtain long-period curative effects. Simple decompression is considered aiatrogenic destabilization of lumbar vertebra, and aggravates lumbar malformation. OBJECTIVE:To analyze the effectiveness of posterior decompression, fixation and fusion in the treatment of degenerative lumbar scoliosis with stenosis and to evaluate corrective angle during half-year fol ow-up. METHODS:A total of 23 cases of degenerative lumbar scoliosis with stenosis underwent posterior decompression, fixation and fusion. Visual Analogue Scale, Oswestry disability index, 36-Item Short-Form Health Survey scale and the Cobb angle on the lumbar coronal film were used to assess the changes in quality of life and corrective angle before treatment and during final fol ow-up. RESULTS AND CONCLUSION:Al patients were fol owed up for at least 6 mouths. Mean Cobb angles were (23.94±11.4)° pretreatment and (10.28±6.93)° posttreatment. Mean Visual Analogue Scale scores were significantly lower posttreatment than pretreatment (P<0.05). Oswestry disability index scores were significantly lower posttreatment than pretreatment (P<0.05). The excellent and good rate of Oswestry disability index score was 83.33%. The eight scaled scores of 36-Item Short-Form Health Survey scale were significantly higher posttreatment than pretreatment (P<0.05). During half-year fol ow-up, there was no obvious loss in corrective angle. Shift of interbody cages was not displaced. No internal fixator breakage appeared. The rate of fusion for bone graft was 100%.