退变性脊柱侧凸手术融合节段选择的研究进展

RESEARCH PROGRESS OF SURGICAL SELECTION OF FUSION LEVELS FOR DEGENERATIVE SCOLIOSIS

目的对退变性脊柱侧凸手术融合节段选择的研究进展进行综述。方法广泛查阅国内外退变性脊柱侧凸相关文献,并对其临床特点、分型标准及术式选择、固定融合节段选择等方面进行总结、分析。结果退变性脊柱侧凸临床特点复杂,其手术治疗主要包括长节段与短节段固定融合。其中,长节段固定融合在重建脊柱稳定性方面效果较好,但相关并发症较多;短节段固定融合应用广泛,但易造成邻近节段退变性疾病。W/AL值可用于指导融合节段的选择。结论选择合理的固定融合节段是手术成功关键,但目前尚无统一选择标准,有待进一步研究。

Objective To summarize the progress of the surgical selection of fusion levels for degenerative scoliosis. Methods The domestic and foreign related literature about degenerative scoliosis, including clinical features, classification, surgical treatment, and the fused segment, was summarized. Results Degenerative scoliosis is very complicated. Short segment fusion and long segment fusion are the main surgical types. The long segment fusion is better in terms of reconstructing the stability of spine; however, it has more related complications. The short segment fusion has been used widely in clinical, but it causes degenerative disease easily. W/AL value can be used to direct the selection of short or long segment fusion for degenerative scoliosis. Conclusion The key to success surgery is choosing reasonable fused segment. Now there is no unified selection standard. With more knowledge about degenerative scoliosis, greater development can be expected in the future.