根据症状特点选择术式治疗退行性脊柱侧凸的疗效观察

Clinical Research on Different Surgical Treatment for Degenerative Scoliosis Based on Symptom Characteristics

目的:评估根据症状特点采取不同术式治疗退行性脊柱侧凸的临床疗效。方法:退行性脊柱侧凸55例,根据主要症状分为A,B两组。A组19例,以腰背痛为主,行长节段矫形内固定术;B组36例,以下肢症状为主,行责任节段减压内固定术。记录手术时间、出血量、术前、术后及末次随访时侧凸Cobb角及腰前凸度数;采用VAS评分、ODI量表评估患者术后症状缓解和功能改善情况。结果:两组患者术后VAS和ODI评分与术前相比差异有统计学意义(P<0.05),组间比较差异无统计学意义(P>0.05)。A组手术时间、出血量大于B组,差异有统计学意义(P<0.05)。结论:根据退行性脊柱侧凸的症状特点,选择不同术式可获得良好的治疗效果。长节段固定手术时间长、出血量多,应注意防止围手术期相关并发症的发生。

Objective：To evaluate the effects of different surgical treatment for degenerative scoliosis based on symptom characteristics.Methods：55patients with degenerative scoliosis were divided into two groups according on main clinical symptoms.Group A（low back pain as the main symptoms）has 19 cases,long segment internal fixation and correction were performed.Group B（Lower limbs discomforts as the main symptoms）has 36 cases,posterior responsibility segments decompression and fusion were performed.The operation time,blood loss,Cobb angle and lumbar lordosis were recorded.The clinical outcomes were evaluated by VAS score and Oswestry Disability Index（ODI）.Results：The difference of VAS and ODI scores before and after surgery in the two groups was statistically significant（P〈0.05）,and there was no significant difference between the two groups（P〉0.05）.The operation time and blood loss of A group were higher than that of B group,and the difference was statistically significant（P〈0.05）.Conclusion：Different surgical treatment for degenerative scoliosis based on symptom characteristics can relieve patients＇ symptoms and improve quality of life.Long segments internal fixation should pay attention to perioperative complications related to great trauma.