CAJ | 학술논문

目的：探讨后路选择性减压、椎弓根螺钉内固定、椎体间植骨融合治疗退行性脊柱侧凸的手术方法及临床效果。方法回顾性分析我院骨科2005年8月至2012年6月，后路手术治疗32例退行性脊柱侧凸患者的病例资料。对患者术前及术后行Oswestry功能障碍指数评分、下腰痛JOA评分，并用JOA改善率评估手术疗效。结果32例患者均行后路手术治疗，手术均顺利完成，无死亡病例，术后平均随访3.4年，影像学检查无钉棒松动、断裂，无术后继发性脊柱侧凸畸形。Oswestry功能障碍指数评分术前、术后6个月、术后2年分别为：(61.35±15.68)分、(26.21±16.32)分、(22.32±9.58)分，差异有统计学意义( P＜0.05)；术前、术后6个月、术后2年JOA下腰痛评分为：(12.26±2.34)分、(15.28±2.32)分、(23.86±2.67)分，差异有统计学意义(P＜0.05)；JOA改善优良率达88.3％。结论选择性后路减压、椎间植骨融合、椎弓根螺钉固定、适当矫形重建脊柱平衡，有利于提高退行性脊柱侧凸患者生活质量，是治疗退变性腰椎侧凸的一种有效方法。
목적：탐토후로선택성감압、추궁근라정내고정、추체간식골융합치료퇴행성척주측철적수술방법급림상효과。방법회고성분석아원골과2005년8월지2012년6월，후로수술치료32례퇴행성척주측철환자적병례자료。대환자술전급술후행Oswestry공능장애지수평분、하요통JOA평분，병용JOA개선솔평고수술료효。결과32례환자균행후로수술치료，수술균순리완성，무사망병례，술후평균수방3.4년，영상학검사무정봉송동、단렬，무술후계발성척주측철기형。Oswestry공능장애지수평분술전、술후6개월、술후2년분별위：(61.35±15.68)분、(26.21±16.32)분、(22.32±9.58)분，차이유통계학의의( P＜0.05)；술전、술후6개월、술후2년JOA하요통평분위：(12.26±2.34)분、(15.28±2.32)분、(23.86±2.67)분，차이유통계학의의(P＜0.05)；JOA개선우량솔체88.3％。결론선택성후로감압、추간식골융합、추궁근라정고정、괄당교형중건척주평형，유리우제고퇴행성척주측철환자생활질량，시치료퇴변성요추측철적일충유효방법。
Objective To investigate the surgical method of selective posterior decompression, pedicle screw ifxation and interbody fusion in the treatment of degenerative scoliosis ( DS ) and the clinical results.Methods 32 patients with DS underwent posterior surgical treatment in our Department from August 2005 to June 2012, whose data were retrospectively analyzed. The Oswestry Disability Index ( ODI ) scores, Japanese Orthopedic Association ( JOA ) scores of low back pain and the improvement rate of JOA scores were used to evaluate the preoperative and postoperative results.Results 32 patients underwent posterior surgical treatment, which was successfully completed with no death. All patients were followed up for an average period of 3.4 years postoperatively. According to the imaging examination, no loosening, breakage or secondary scoliosis was found. The ODI scores were ( 61.35±15.68 ) points, ( 26.21±16.32 ) points and ( 22.32±9.58 ) points respectively before the operation and at 6 and 24 months after the operation, and the differences were statistically signiifcant (P<0.05 ). The JOA scores of low back pain were ( 12.26±2.34 ) points, ( 15.28±2.32 ) points, ( 23.86±2.67 ) points before the operation and at 6 and 24 months after the operation, and the differences were statistically signiifcant (P<0.05 ). The improvement rate of JOA scores was 88.3%. Conclusions The surgical method of selective posterior decompression, interbody fusion, pedicle screw ifxation and reconstruction of the spinal balance after appropriate correction is effective in the treatment of DS, which can improve the life quality of patients with DS.