后路选择性减压植骨融合内固定在退变性脊柱侧弯中的应用研究

Application of Posterior Selective Decompression,Bone Graft Fusion and Internal Fixation in Degenerative Scoliosis

目的探讨后路选择性减压植骨融合内固定在退变性脊柱侧弯中的应用效果。方法选择2019年2月—2021年1月期间该院收治的退变性脊柱侧弯患者98例,以随机数字表将其分为两组,各49例。对照组采取常规保守治疗方案,研究组行后路选择性减压植骨融合内固定术。比较两组治疗前后腰椎前凸角与Cobb角、疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、脊柱侧凸协会生活质量22问卷(SRS-22),以及并发症情况。结果治疗后,研究组腰椎前凸角(25.65±5.85)°、Cobb角(13.65±2.54)°较对照组(31.20±4.98)°、(18.65±4.88)°低,差异有统计学意义(t=5.057、6.362,P<0.05);研究组VAS(1.22±0.57)分、ODI评分(20.52±5.65)分较对照组(4.22±1.03)分、(35.50±4.78)分低,差异有统计学意义(t=17.839、14.169,P<0.05);研究组功能活动(23.02±3.03)分、心理状况(23.02±2.03)分、自我形象(23.49±1.20)分、治疗满意度评分(9.52±1.02)分较对照组(16.52±2.98)分、(20.00±2.54)分、(21.52±1.03)分、(6.50±1.32)分高,差异有统计学意义(t=10.706、6.501、8.720、12.673,P<0.05)。研究组并发症发生率4.08%与对照组0.00%对比,差异无统计学意义(χ2=0.510,P>0.05)。结论退变性脊柱侧弯患者应用后路选择性减压植骨融合内固定治疗能够有效改善疼痛症状,提高椎体功能,保障生活质量。

Objective To investigate the effect of posterior selective decompression and bone graft fusion and internal fixation in degenerative scoliosis.Methods A total of 98 patients with degenerative scoliosis admitted to the hospital from February 2019 to January 2021 were selected.They were divided into two groups with a random number table,each with 49 cases.The control group took a conventional conservative treatment plan,and the study group underwent posterior selective decompression,bone graft fusion and internal fixation.The lumbar lordosis angle and Cobb angle,pain visual analog scale(VAS),Oswestry dysfunction index(ODI),and Scoliosis Association Quality of Life 22 Questionnaire(SRS-22)and complications were compared between the two groups before and after treatment.Results After treatment,the lumbar lordosis angle(25.65±5.85)°and Cobb angle(13.65±2.54)°in the study group were lower than those in the control group(31.20±4.98)°and(18.65±4.88)°,the difference was statistically significant(t=5.057,6.362,P<0.05).The scores of VAS(1.22±0.57)points and ODI score(20.52±5.65)points of the study group were lower than those of the control group(4.22±1.03)points and(35.50±4.78)points,the difference was statistically significant(t=17.839,14.169,P<0.05).The study group had scores of functional activity(23.02±3.03)points,psychological status(23.02±2.03)points,self-image(23.49±1.20)points,and treatment satisfaction score(9.52±1.02)points.Compared with the control group(16.52±2.98)points,(20.00±2.54)points,(21.52±1.03)points,(6.50±1.32)points higher,the difference was statistically significant(t=10.706,6.501,8.720,12.673,P<0.05).The complication rate of the study group was 4.08%compared with 0.00%of the control group,and there was no difference,the difference was statistically significant(χ2=0.510,P>0.05).Conclusion The use of posterior selective decompression and bone graft fusion and internal fixation for patients with degenerative scoliosis can effectively improve pain symptoms,improve vertebral body function,and ensure the quality of life.