脊柱侧弯手术治疗的临床研究

Clinical study on curative effect in surgery-treated scoliosis patients

目的分析和总结脊柱侧弯患者手术治疗疗效的各种影响因素,为该病的治疗和预后提供参考。方法对2005-10～2008-07骨科手术治疗的75例脊柱侧弯患者进行随访观察,记录患者术后侧弯矫正效果和植骨融合情况,并根据其性别、年龄、脊柱侧弯类型、侧弯原始角度、手术入路、手术方式、植骨方式、植骨来源、内固定系统进行分组统计,分析和总结侧弯患者手术治疗疗效的各种潜在影响因素。结果不同年龄、不同角度以及不同手术方式的脊柱侧弯患者间分别比较,侧弯矫正良好率的差异有统计学意义(P<0.05),而不同性别、不同侧弯类型、不同手术入路以及不同内固定系统的患者间分别比较,矫正良好率无统计学义差异(P>0.05)。不同植骨方式、不同来源的患者之间分别比较,植骨融合率亦无统计学差异(P>0.05)。结论脊柱侧弯疾病复杂,手术治疗在方式、入路、时机的选择上应根据患者的年龄、侧弯原始度数、骨骼成熟度、脊柱柔韧性、躯干的平衡情况等因素进行综合考量。

Objective To analyze and summary the influential factors of seoliosis, and to provide a reference for its treatment and prognosis. Methods The curative effect and bone graft fusion of 75 surgery-treated patients with scoliosis were recorded. According to sexuality, age, seoliosis type, rudimentary horn, operative approach, modus operandi, bone graft way, bone resource and internal fixation system, the patients were grouped, respectively. Then the influential factors were analyzed and summarized. Results According to various factors, the good correction rate for scoliosis was significantly different in different age groups, different rudimentary hom groups, as well as different modus operandi groups, respectively（ P 〈 0.05）, but not significantly different in different sexuality groups, different scoliosis type groups, different operative approach groups, different internal fixation system groups, respectively（ P 〉 0.05）. The rate of graft fusion in patients with different bone graft ways and resources had no significant difference, respectively（P 〉 0.05）. Conclusion The operation modality, approach and opportunity should be chosen based on age, rudimentary horn, skeletal maturation, spinal flexibility and truncal balance.