合并椎管狭窄的退变性腰椎侧弯经后路手术治疗效果

Effect of Posterior Approach Operative Treatment for Degenerative Lumbar Scoliosis Combined with Spinal Canal Stenosis

目的探讨经后路手术治疗合并椎管狭窄退变性腰椎侧弯的临床疗效。方法随机选取2014年8月—2015年8月该院收治的退变性腰椎侧弯合并椎管狭窄患者100例,均经后路实施手术治疗,观察患者术后腰背痛症状变化、神经源性间歇性跛行缓解、足下垂、并发症、死亡及腰椎前凸角、冠状面平均Cobb角变化、VAS评分情况。结果术后有88例患者腰背疼痛症状明显缓解。神经源性间歇性跛行患者比例减至1.0%、足下垂患者比例减至0.0%,明显小于术前;腰椎前凸角矫正为-45^-16°,明显小于术前;冠状面平均Cobb角矫正为0~21°,明显小于术前;VAS评分为(0.78±0.22)分,明显低于术前,差异有统计学意义(P<0.05)。结论经后路手术治疗合并椎管狭窄退变性腰椎侧弯具有良好的疗效,可有效缓解临床症状,实现彻底神经减压。

Objective To observe th e c l in ic a l cu ra t iv e effect of pos te rio r ap p ro ach o perat ive tre a tm en t for d eg en erative lum -bar scoliosis combined with spinal canal stenosis . Methods Random sele ct ion 100 c a se s of p a t ien ts with d eg en erative lum -bar scoliosis combined with spinal canal s tenosis admit ted and treated in our hospi tal from August 2014 to August 2015 were selected and treated with posterior approach operat ion, and the postoperative lumbago and backache symptom changes, neurogenic intermi t tent claudicat ion relief, foot drop, complicat ion, death, lumbar lordosis, coronal sect ion average Cobb an-gle change and VAS score of pat ients were observed. Results The lumbago an d b ack p a in symptoms of 88 c a se s af te r o p e r -at ion were obviously relieved, and the ratio of pat ients with neurogenic intermi t tent claudicat ion decreased to 1.0%, and the ratio of pat ients with foot drop decreased to 0.0%, which was obviously fewer than that before operat ion, the range degree of lumbar lordosis correction was between -45〇 and - 1 6 .,which was obviously less th an before ope rat io n, and th e average range degree of coronal sect ion Cobb angle correction was between 0 and 21. , which was obviously less th an th a t before operat ion, and the VAS score was（0.78±0.22）points, which was obviously lower than that before operat ion, and the difference had stat ist ical signi ficance（P〈0.05）. Conclusion T he cu ra t iv e effect of pos te rio r ap p ro a ch ope rat iv e tre a tm en t for d e g e n -erat ive lumbar scoliosis combined with spinal canal s tenosis is good, which can effectively relieve the cl inical symptoms andreal ize the completed neurological decompression.