CAJ | 학술논문

目的：探讨选择性减压融合、椎弓根螺钉矫形术治疗严重退变性腰椎侧凸的临床疗效。方法对2009年3月-2011年8月收治的23例严重退变性腰椎侧凸患者，采取选择性后路减压并植骨融合、长节段椎弓根螺钉矫形固定。测量记录患者术前、首次随访和末次随访的侧凸Cobb角及Oswestry功能障碍指数( ODI)，并对测量值进行统计学分析。结果患者术后随访18~27个月，平均21.3个月。术后3个月及末次随访ODI功能评分、Cobb角与术前比较，差异均有统计学意义(P<0．001)。随访期间无明显矫形度的丢失和内固定失败发生。结论对严重退行性腰椎侧凸患者行选择性减压矫形内固定术疗效满意，个性化的治疗方案尤其重要。
목적：탐토선택성감압융합、추궁근라정교형술치료엄중퇴변성요추측철적림상료효。방법대2009년3월-2011년8월수치적23례엄중퇴변성요추측철환자，채취선택성후로감압병식골융합、장절단추궁근라정교형고정。측량기록환자술전、수차수방화말차수방적측철Cobb각급Oswestry공능장애지수( ODI)，병대측량치진행통계학분석。결과환자술후수방18~27개월，평균21.3개월。술후3개월급말차수방ODI공능평분、Cobb각여술전비교，차이균유통계학의의(P<0．001)。수방기간무명현교형도적주실화내고정실패발생。결론대엄중퇴행성요추측철환자행선택성감압교형내고정술료효만의，개성화적치료방안우기중요。
Objective To investigate the clinical effect of selective posterior decompression and fusion combined with pedicle screws of orthomorphia in treatment of severe degenerative lumbar scoliosis ( DLS) . Methods A total of 23 DLS patients during March 2009 and August 2011 underwent selective posterior decompression and fusion combined with long-segment pedicle screws of orthomorphia and internal fixation. Scoliosis Cobb's angles and Oswestry disability index ( ODI) were measured before the operation, during the first and last follow-up, and the values were statistically analyzed. Results All the patients were followed up for 18-27 months, and the average time was 21. 3 months. The values of ODI and Scoliosis Cobb's angles in postoperative 3 months and in the last follow-up were statistical differences compared with those before the operation (P<0. 001). The correction degree was no obviously lost, and no internal fixation failure was found during the follow-up period. Conclusion Selective posterior decompression and fusion combined with pedicle screws of orthomorphia in treatment of severe degenerative lumbar scoliosis can achieve satisfactory effects, and the indi-vidualized treatment may be the best choice.