长节段融合联合后路椎弓根螺钉系统内固定术治疗退变性脊柱侧弯患者的效果

Effects of Long Segment Fusion Combined with Posterior Pedicle Screw System Internal Fixation in Patients with Degenerative Scoliosis

目的 研究长节段融合联合后路椎弓根螺钉系统内固定术治疗退变性脊柱侧弯(DS)患者的效果。方法 选取汝州市人民医院接收的94例DS患者,随机分为研究组与对照组,各47例。两组均接受后路椎弓根螺钉系统内固定术,研究组加用长节段融合,对照组加用短节段融合。对比两组手术相关指标、疼痛度、腰椎功能、影像学指标、脊柱平衡指标及并发症发生情况。结果 研究组术中出血量多于对照组,手术时间、住院时间长于对照组,完全负重时间、下地行走时间短于对照组(P<0.05);术后3、6个月,研究组视觉模拟评分、Oswestry功能障碍指数低于对照组,后凸、侧凸Cobb角及矢状面平衡、冠状面平衡低于对照组(P<0.05);研究组侧凸进展发生率低于对照组(P<0.05)。结论 长节段融合联合后路椎弓根螺钉系统内固定术治疗DS患者可减轻疼痛度,改善腰椎功能,维持脊柱稳定,且并发症较少。

Objective To study the effects of long segment fusion combined with posterior pedicle screw system internal fixation in patients with degenerative scoliosis(DS).Methods A total of 94 DS patients admitted to Ruzhou People’s Hospital were collected and divided into study group and control group randomly,with 47 cases in each group.Both groups underwent posterior pedicle screw system internal fixation.The study group added long segment fusion,and the control group added short segment fusion.The operation related indexes,pain,lumbar function,imaging indexes,spinal balance indexes and complications were compared between the two groups.Results The intraoperative blood loss in study group was more than that in control group,the operation time and hospital stay were longer than those in control group,and the complete weight-bearing time and walking time were shorter than those in control group(P<0.05).At 3 and 6 months after operation,visual analogue scale and Oswestry dability index in study group were lower than those in control group,and the posterior convexity,lateral convexity Cobb angle,sagittal balance and coronal balance were lower than those in control group(P<0.05).The incidence of scoliosis progression in study group was lower than that in control group(P<0.05).Conclusion Long segment fusion combined with posterior pedicle screw system internal fixation can reduce pain level of patients with DS,improve lumbar function,maintain spinal stability,and have fewer complications.