动态固定系统与短节段减压融合内固定治疗退行性脊柱侧凸症的临床价值

Comparison of clinical value of dynamic fixation system and short segment decompression fusion and internal fixation in the treatment of degenerative scoliosis

目的评价动态固定系统与短节段减压融合内固定治疗退行性脊柱侧凸症的临床价值。方法2016年3月~2019年7月我院接受矫形手术的退行性脊柱侧凸症病人96例,将96例病人分为两组,对照组48例,采用短节段减压融合内固定。观察组48例,采用动态固定系统。比较两组病人手术相关情况、围术期并发症、临床症状改善情况、矫形效果、临床疗效等。结果与对照组比较,观察组术中出血量、手术时间、术后引流量、住院时间均明显减少(P<0.05),观察组围术期并发症发生率降低,差异有统计学意义(P<0.05)。与手术前比较,两组病人的VAS评分与ODI指数均有所改善,且末次随访时观察组优于对照组(P<0.05);两组病人腰椎侧凸Cobb角明显改善,但末次随访时观察组矫形效果低于对照组(P<0.05)。与对照组相比,观察组病人术后邻近关节活动度更优、总有效率明显升高(P<0.05)。结论采用动态固定系统治疗退行性脊柱侧凸症较短节段减压融合内固定术中出血量小,手术时间间短,术后引流量少,并发症风险小,在临床症状改善方面更具优势,临床疗效显著。

Objective To evaluate the clinical value of dynamic fixation system and short segment decompression fusion and internal fixation in the treatment of degenerative scoliosis.Methods The clinical data of 96 patients with degenerative scoliosis who underwent orthopaedic surgery in our hospital from March 2016 to July 2019 were analyzed retrospectively.48 patients in the control group were treated with short segment decompression fusion and internal fixation.48 patients in the observation group were treated with dynamic fixation system.The operation related situation,clinical symptom improvement,orthopedic effect,clinical curative effect and complications were observed and compared between the two groups.Results Compared with the control group,the intraoperative blood loss,operation time,postoperative drainage volume and hospital stays in the observation group were significantly lower than those in the control group(P<0.05).The incidence of perioperative complications decreased in the observation group(P<0.05).Compared with that before operation,the VAS score and ODI index of the two groups were improved,and the observation group was significantly better than the control group at the last follow-up(P<0.05).Compared with before operation,the Cobb angle of lumbar scoliosis in the two groups was significantly improved,and at the last follow-up,the observation group was significantly better than the control group(P<0.05).Compared with the control group,the patients in the observation group had better range of motion of adjacent joints after operation and the total effective rate was significantly increased(P<0.05).Conclusion Compared with short segment decompression,fusion and internal fixation,dynamic fixation system has the advantages of less bleeding,shorter operation time and less postoperative drainage in the treatment of degenerative scoliosis,and has more advantages in the improvement of clinical symptoms and orthopedic effect.The clinical curative effect is remarkable,at the same time can significantly reduce the risk of complications.