后路椎弓根钉棒系统治疗退行性脊柱侧弯的疗效分析

Curative effect analysis of posterior pedicle screw rod system in the treatment of degenerative scoliosis

目的探讨后路椎弓根钉棒系统治疗退行性脊柱侧弯对患者椎体功能恢复以及神经功能的影响。方法选取2012年1月至2017年3月我院接诊的98例退行性脊柱侧弯患者,根据治疗方法不同分为观察组(n=50)和对照组(n=48)。观察组给予患者后路椎弓根钉棒系统治疗,对照组给予患者椎管减压术治疗。对比2组患者治疗后临床效果,记录术前、术后即刻、术后6个月腰椎前凸角度、Cobb角度、Oswestry功能障碍指数(ODI)评分、JOA评分变化,比较治疗前后胫神经、腓总神经、腓浅神经、腓肠神经、躯体功能、物质生活、心理功能变化。结果观察组总有效率94. 00%,明显高于对照组的77. 08%,差异具有统计学意义(P <0. 05);术后即刻、术后6个月2组患者Cobb角均有降低,观察组低于对照组,差异具有统计学意义(P <0. 05);术后即刻、术后6个月2组患者腰椎前凸角度均有升高,ODI评分降低、JOA评分升高,观察组改善效果优于对照组,差异具有统计学意义(P <0. 05)。治疗后,2组患者胫神经、腓总神经、腓浅神经、腓肠神经传导速度均高于治疗前,差异具有统计学意义(P <0. 05);且观察组以上指标明显高于对照组,差异具有统计学意义(P <0. 05);治疗后,2组患者躯体功能、物质生活、心理功能等生活质量指标评分均高于治疗前,且观察组以上指标明显高于对照组,差异具有统计学意义(P <0. 05)。结论后路椎弓根钉棒系统治疗退行性脊柱侧弯患者,可有效矫正患者脊柱侧弯,恢复腰椎功能,优化神经功能,提高患者生活质量。

Objective To investigate the effect of posterior pedicle screw rod system on vertebral functional recovery and neurological function in patients with degenerative scoliosis.Methods A total of98cases of degenerative scoliosis were selected in our hospital from January2012to March2017.According to the different treatment methods,the patients were divided into the observation group(n=50)and the control group(n=48).The patients were compared with the lumbar lordosis angle,Cobb angle,the Oswestry dysfunction index(ODI score)and the JOA score before and after the operation.The tibial nerve,the common peroneal nerve,the superficial peroneal nerve,the nervus suralis,the body function,the material life and the psychological states were compared before and after the treatment between the two groups.Results After treatment,the total effective rate of the observation group was94.00%,which was higher than77.08%of the control group,the difference was significant(P<0.05).The Cobb angle of the two groups was reduced immediately after the operation and6months after the operation,and it was lower in the observation group compared with the control group,the difference was significant(P<0.05).The angle of the lumbar lordosis increased,the ODI score decreased,and the JOA score increased in the two groups immediately after the operation and6months after the operation.And the improvement effect of the observation group was better than that of the control group,the difference was significant(P<0.05).After treatment,the conduction velocity of the tibial nerve,the common peroneal nerve,the superficial peroneal nerve and the nervus suralis of the two groups were faster than those before the treatment,the differences were significant(P<0.05),and the indexes above in the observation group were significantly higher than those of the control group,the differences were significant(P<0.05).After treatment,the scores of the body function,the material life and the psychological states of the two groups were higher than those before the treatment,the differences were significant(P<0.05),and the indexes above in the observation group were significantly higher than those in the control group,the difference was significant(P<0.05).Conclusion The posterior pedicle screw rod system treatment for the patients with degenerative scoliosis can effectively correct the scoliosis and restore the function of the lumbar spine.And it can optimize the nerve function and improve the life quality of the patients.