椎板关节突截骨治疗中重度退行性脊柱侧凸近期疗效观察

Short-term Effect Observation of Lamina Facet Osteotomy in Treatment of Moderate-severe Degenerative Scoliosis

目的探讨中重度退行性脊柱侧凸的后路截骨术治疗方法和临床效果。方法 2012年1月—2013年12月对9例中重度退行性脊柱侧凸患者采用了后路选择性经椎板关节突截骨、减压、椎弓根螺钉内固定去旋转矫形术治疗,对其近期疗效进行观察。结果与本组术前相比,JOA评分、Cobb角均有明显改善,差异有统计学意义(P<0.05),4例患者有轻度下肢疼痛、麻木,无其他并发症。结论后路选择性椎板关节突截骨椎弓根螺钉内固定旋转矫形手术治疗中重度退行性脊柱侧凸可起到减压、矫形、融合、重建脊柱稳定性的目的,近期效果满意。

Objective To investigate the methods and the clinical effect of posterior osteotomy in treatment of moderate-severe degenerative scoliosis. Methods Nine patients with moderate-severe degenerative scoliosis during Janu-ary 2012 and December 2013 underwent selective posterior lamina facet osteotomy combined with decompression and ped-icle screw internal fixation rotating orthopedic operation, and the short-term effects of the nine patients were observed. Results Compared with those before the operation, JOA score and Cobb angles were significantly improved, and the differences were statistically significant （P〈0. 05）;4 patients had mild lower-extremity pain and numbness, but no oth-er complications were found. Conclusion Selective posterior lamina facet osteotomy combined with pedicle screw inter-nal fixation rotating orthopedic operation in treatment of moderate-severe degenerative scoliosis may achieve decompres-sion, orthotics, fusion and spinal stability reconstruction with good short-term effect.