退变性腰椎侧凸合并椎管狭窄的阶梯性治疗

Ladder Treatment of Degenerative Lumbar Scoliosis with Spinal Stenosis

目的分析退变性腰椎侧凸合并椎管狭窄的阶梯性治疗效果。方法研究阶段为2013年7月1日-2018年6月30日,共纳入研究对象80例,均为退变性腰椎侧凸合并椎管狭窄患者,采用随机数字表法分为2组,对照组采用保守治疗,治疗组采用阶梯性治疗,对比2组临床效果。结果 2组在前凸角、侧凸Cobb角、治疗前和术后7天VAS评分、治疗前和术后7天ODI差异不显著无统计学意义(P>0.05);对照组前凸角(16.33±9.98)°和侧凸Cobb角(21.32±8.11)°、术后90天VAS评分为(5.68±0.71)分、术后90天ODI为(30.76±8.22)分与治疗组前凸角(32.92±10.12)°和侧凸Cobb角(7.47±5.43)°、术后90天VAS评分(2.32±0.63)分、术后90天ODI(23.66±7.05)分差异显著具有统计学意义(P<0.05)。对照组随访与差异显著具有统计学意义(P<0.05)。对比2组SF-36中8个维度的得分情况,可以发现治疗组的SF-36评分优于对照组,差异显著具有统计学意义(P<0.05)。结论针对DLSS患者的治疗,应该充分结合患者临床资料、病情具体情况选择最佳的治疗方案,在治疗过程中结合阶梯性治疗的理念,在准确判断责任节段的基础上有效提高临床治疗效果。

Objective To analysis of degenerative lumbar scoliosis with spinal stenosis of the ladder treatment. Methods The study stage was July 1 st, 2013 to June 30 th, 2018, were included in the study of 80 cases,were degenerative lumbar scoliosis and spinal stenosis patients, using random number table method is divided into two groups, one group Conservative treatment(control group), a group of patients with step therapy(treatment group), compared the two groups of clinical effects. Results There was no significant difference in VAS score between the two groups before the angle of the lordosis, the Cobb angle, the preoperative and postoperative 7 days, and there was no significant difference between the two groups before and after 7 days(P>0.05), the lordosis angle of the control group(16.33(30.96 ± 8.22) and the lordosis angle(32.92 ± 10.12) of the treatment group were significantly higher than those of the control group(P<0.05)(7.47 ± 5.43), VAS score(2.32 ± 0.63)after 90 days, and ODI(23.66 ± 7.05) at 90 days after operation was significantly statistically significant(P<0.05).There was significant difference between the control group and the control group(P<0.05). Compared with the scores of 8 dimensions in SF-36, the SF-36 score of the treatment group was better than that of the control group,the difference was statistically significant(P<0.05).Conclusions For the treatment of patients with DLSS, should be fully combined with the patient’s clinical data, the specific circumstances of the disease to choose the best treatment in the treatment process combined with the concept of ladder treatment, accurate judgment on the basis of the effective segment to improve clinical treatment.