后路长、短节段固定结合有限减压治疗退变性腰椎侧凸的比较研究

Abstract

Abstract:

Objective　To compare clinical and radiographic outcomes of patients with degenerative lumbar scoliosis, treated by two kinds of posterior surgery.　Methods　Clinical and radiographic outcomes of 46 patients with degenerative lumbar scoliosis, and treated by two kinds of posterior surgery, were analyzed retrospectively. short-segment fixation was taken as group A（2.7±0.6, n=26）, and long-segment fixation as group B（5.6±1.4, n=20）. The lumbocrural pain and activity function were evaluated by JOA and VAS scores. The Cobb's angles were measured to assess the lumbar scoliosis and kyphosis. The clinical and radiographic outcomes, including surgery time, blooding and surgery complications were compared between two groups.　Results　The mean follow-up was 2.8 years (2~6.5) for all patients. The blooding and surgery time of group A was significantly more than that of group B（Pt<0.001, Pb<0.001）；The scoliosis angles of pre-operative was 22±4.6°(group A) and 28±7.3°(group B) respectively, and 11±3.8°(group A) and 12±5.9°(group B) at the end of follow-up. The recovery rate of group A was better than that of group B(P<0.001). The lumbar lordosis angles of the preoperative was 19±4.6°(group A) and 18±7.3°(group B), and improved to 29±3.8°(group A) and 32±5.9°(group B) at final follow-up. The correction rate of two groups had no significant difference（P=0.17）. The JOA score of the preoperative and fellow-up was 14±3.6, 23±4.7(group A) and 13±3.8, 21±5.9（group B）respectively, and both improved after surgery. The improve rate of two groups have no difference（P=0.24）. The VAS score of the preoperative and fellow-up was 8±0.16, 3±0.07(group A) and 8±1.8, 4±2.7（group B）, and both improved after surgery. The improve rate of two groups had no difference（P=0.22）. The complication incidence of group B was significant higher than group A（P<0.001）.　Conclusion　Although the scoliosis correction rate of long-segment fixation group is higher, the lumbar lordosis correction rate and clinical outcome have no significant difference compared to short one. Furthermore, long-segment fixation causes a higher complication rate and worse lumbar functional activity after surgery.

Key words: Degenerative lumbar scoliosis, Decompression, Fixation, Compare

CLC Number:

P682.3

XIE Jin, LONG Hou-Qing, CHEN Ying-Dong, XIE Wen-Han, LI An-Cheng, LIU Shao-Yu, LI Bi-Bao. Posterior limited spinal decompression associated with short and long segments fusion for treating degenerative lumbar scoliosis: a comparative study[J]. Chinese Journal Of Clinical Anatomy, 2012, 30(5): 568-572.

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Posterior limited spinal decompression associated with short and long segments fusion for treating degenerative lumbar scoliosis: a comparative study

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