腰椎融合术对脊柱-骨盆矢状面平衡及疗效的临床观察

Clinical observation and efficacy on lumbar interbody fusion for spine pelvic sagittal balance

目的探讨腰椎退变性疾病采用腰椎融合术治疗对脊柱-骨盆矢状面平衡及临床疗效分析。方法收集2009年6月至2012年6月我院骨科接受腰椎内固定融合手术的92例腰椎退行性疾病患者的临床资料,术后2年内随访患者,对比腰椎前凸角(LL)、腰椎矢状垂直轴(SVA)、骨盆入射角(PI)、骶骨倾斜角(SS)、骨盆倾斜角(PT)等参数数值,采用Oswestry功能障碍指数(ODI)、视觉模拟评分法(VAS)及日本骨科学会(JOA)评分,评估术后疗效。结果脊柱骨盆参数SVA、LL、SS及PT手术后均较术前有明显改变,且差异有统计学意义(P<0.05),术后随访VAS、ODI及JOA评分,均较术前有明显改善,治疗前后统计学差异显著(P<0.05)。结论腰椎融合手术可以恢复腰椎生理前凸,对于维持脊柱-骨盆矢状面平衡和提高手术疗效,改善术后症状有积极意义。

Objective To analyze the clinical therapeutic effect of lumbar fusion in the treatment of lumbar degenerative diseases in the spine pelvic sagittal balance. Methods From June 2009 to June 2012,the clinical data of 92 cases with lumbar degenerative diseases accepted lumbar spinal fusion operation in our hospital was collected. The contrast lumbar lordosis（ LL）,lumbar sagittal vertical axis（ SVA）,pelvic incidence angle（ PI）,sacral inclination angle（ SS）,pelvic tilt angle（ PT） and other numerical parameters,using the Oswestry disability index（ ODI）,visual analogue scale（ VAS） and the Japan Society of Department of orthopedics（ JOA） score were followed up two years after operation,and the postoperative effect was evaluated. Results The spinal pelvic parameters SVA,LL,SS and PT after surgery were changed obviously,and the difference was statistically significant（ P〈 0. 05）. The postoperative follow-up of VAS,ODI and JOA score were better than that of preoperation,the difference was significant（ P〈 0. 05）. Conclusion Lumbar fusion operation can restore lumbar lordosis,to maintain the spine pelvic sagittal balance and improve the effect of operation,and have positive significance to improve the postoperative symptoms.