腰椎后路钉棒固定术中曲度矫正的临床意义

Clinical significance of application of posterior internal fixation for regulating lumbar curvature

目的探讨腰椎后路钉棒固定术中曲度矫正与术后疗效是否存在相关性。方法 2006-01-2010-01月,回顾性分析98例腰椎管狭窄症患者。A组行传统腰后路椎板减压椎间植骨内固定手术。B组术中常规钉棒系统加压。C组术中C型臂透视下矫正腰椎曲度。对患者术后腰椎曲度、椎间隙高度、内固定系统松动及断裂情况进行比较,应用VAS及ODI对下腰部及双下肢疼痛症状评分。结果三组术后腰椎曲度丢失及椎间隙高度比较有统计学意义。C组无断钉脱钉断棒发生,A组发生率为10%,B组为6.1%。C组腰痛VAS及ODI评分改善与A、B组比较有统计学意义。结论腰椎后路钉棒固定术中曲度矫正临床效果良好,明显恢复腰椎生理曲度、增加椎间隙高度恢复、降低断钉脱钉断棒发生率,改善患者术后腰痛症状。

Objective To investigate the clinical significance of applicating posterior internal fix- ation for regulating lumbar curvature in lumbar stenosis. Methods From January 2006 to January 2010,98 patients of lumbar stenosis were reviewed in this study. Among them,30 patients received traditional posterior internal fixation in group A. 33 patients were regulated the lumbar curvature and intervertebal height without x-ray in group B. 35 patients were randomized to undergo posterior in- ternal fixation with modified techniques in group C. The lumbar curvature, height of disc space and fracture of the fixation system were compared among three groups. The recovery rate was calculated using VAS and ODI scores for each patient. Results The lost of lumbar curvature is significant difference among three groups. There is significant difference of intervertebal height among three groups. There is no fracture of the fixation system in group C. However,the fracture and loosening rate of fixation system was 10% in group A and 6.1% in group B. The difference of ODI and VAS scores for low back pain were statistically significant among three groups. Conclusion Application of posterior internal fixation for regulating lumbar curvature has a good clinical outcome.