退行性腰椎侧凸的手术治疗选择

The choice of surgical treatment of degenerative lumbar scoliosis

[目的]探讨退行性腰椎侧凸手术治疗的选择，观察手术治疗的疗效。[方法]回顾分析2010年10月-2013年05月，本院收治的26例经手术治疗的退变性腰椎侧凸病例，根据临床症状、体征和影像学资料，结合患者的身体条件和基础疾病，分别采用单纯减压，后路椎管减压、椎弓根螺钉内固定、椎间植骨融合术治疗退变性腰椎侧凸。观察患者术后症状缓解和功能改善情况。[结果]26例患者均获得随访，术后平均随访27．5个月（24～43个月），术后疼痛VAS评分和Oswestry功能障碍指数的改善率分别为（68．9±2．4）％和（80．5±4．1）％。侧凸平均矫正率（60．4±3．7）％，随访无断钉、断棒发生。[结论]对于退变性腰椎侧凸，应采取个体化治疗，严格掌握手术适应证，治疗以缓解患者症状为主要目的。

[ Objective] To investigate the choice of surgical treatment of degenerative lumbar scoliosis, and to observe the efficacy of surgical treatment. [ Methods ] Twenty - six patients with degenerative lumbar scoliosis after surgical treatment in our hospital during October 2010 to May 2015 were retrospectively reviewed. According to clinical symptoms, signs and imaging da- ta, combined with the patient＇ s physical condition and the underlying disease, the simple decompression, posterior lumbar spinal decompression, pedicle screw internal fixation, and intervertebral bone fusion were used for the treatment of degenerative lumbar scoliosis, respectively. Postoperative symptomatic relief and functional improvement of patients were observed. [ Results] Twenty - six patients were followed up with an average of 27.5 months （24 to 43 months） after operation, and the improvement rate of postoperative pain VAS scores and Oswestry disability index were （68.9 ± 2.4） % and （80. 5 ± 4. 1 ） %, respectively. The average correction rate of scoliosis was （60. 4 ± 3.7） % with no significant loss of correction, no broken nails and broken rods. [ Conclusion] Individualized treatment should be taken for degenerative lumbar scoliosis, and surgical indications should be strictly grasped, and the relief of patients＇ symptoms should be taken as the main purpose in treatment.