后路减压联合短节段或长节段固定融合治疗老年退变性脊柱侧凸疗效分析

Study on the clinical effect of posterior decompression combined with short versus long segment fusion in senile degenerative scoliosis

目的:研究后路减压联合短节段或长节段固定融合治疗老年退变性脊柱侧凸的疗效。方法:选取60例老年退变性脊柱侧凸患者,随机分为两组,每组30例。长节段组患者接受后路减压联合长节段固定融合治疗,短节段组患者接受后路减压联合短节段固定融合治疗,比较两组患者的手术情况、椎间融合情况、近期疗效和远期疗效。结果:(1)长节段组的手术时间长于短节段组,术中出血量、术后引流量多于短节段组,差异具有统计学意义(P<0.05);(2)长节段组患者的融合率高于短节段组,差异具有统计学意义(P<0.05);(3)两组患者的腰部疼痛评分和Cobb角比较,差异无统计学意义(P>0.05),长节段组的ODI评分低于短节段组,差异具有统计学意义(P<0.05)。结论:后路减压联合长节段固定融合治疗的手术创伤虽然较大,但是有助于改善远期疗效,提高椎间融合率,是治疗老年退变性脊柱侧凸的理想方法。

Objective：To study the clinical effect of posterior decompression combined with short versus long segment fusion in senile degenerative scoliosis. Methods： 60 cases of patients with senile degenerative scoliosis were selected, and divided into two groups, each group has 30 cases. The patients in the group of long segment were treated with posterior decompression combined with long segment fusion, and the patients in the group of short segment fusion received posterior decompression combined with short seg- ment. The operation,interbody fusion, short-term efficacy and long-term efficacy in the two groups were compared. Results ： （ 1 ） The op- eration time in the long segment group was longer than that in the short segment group, and the intraoperative blood volume and postop- erative drainage volume were more than these in the short segment group, the difference was statistically significant （P 〈 0.05）. （2） The fusion rate in the patients of long segment group was higher than that in the patients of short segment group ,the difference was sta- tistically significant （P 〈 0.05）. （3）Waist pain score and Cobb angle in the two groups were compared, and the difference was statisti- cally significant （P 〈 0.05 ）. The ODI score was lower than that in the short segment group,and the difference was statistically signifi- cant （P 〈 O. 05 ）. Conclusion：The surgical trauma in the posterior decompression combined long segment fusion was bigger,however,it was conductive to improve the curative effect and interbody fusion rate, was an ideal method for the treatment of senile degenerative scoliosis.