后路手术选择性融合固定治疗退变性脊柱侧弯的效果及对脊柱功能的影响

Effect of posterior surgical selective fusion and fixation in the treatment of degenerative scoliosis and its influence on spinal function

目的研究后路手术选择性融合固定治疗退变性脊柱侧弯的效果及对脊柱功能的影响。方法根据治疗方法的不同,将2018年1月至2020年12月本院收治的108例退变性脊柱侧弯患者分为对照组和观察组,每组54例。对照组实施单纯椎管减压术治疗,观察组实施后路手术选择性融合固定治疗。比较两组的治疗效果。结果观察组的术中出血量多于对照组,手术耗时长于对照组(P<0.05)。术后,两组的视觉模拟评分法(VAS)、Oswestry功能障碍指数问卷(ODI)评分低于术前,日本骨科协会评估治疗分数(JOA)评分高于术前,且观察组优于对照组(P<0.05)。术后,观察组的脊柱Cobb角、骨盆倾斜角小于对照组,腰椎前凸角、骶骨倾斜角大于对照组(P<0.05)。结论后路手术选择性融合固定治疗退变性脊柱侧弯患者的效果显著,可促进脊柱功能改善。

Objective To study the effect of posterior surgical selective fusion and fixation in the treatment of degenerative scoliosis and its influence on spinal function.Methods A total of 108 patients with degenerative scoliosis admitted in our hospital from January 2018 to December 2020 were divided into control group and observation group according to different treatment methods,with 54 cases in each group.The control group was treated with spinal canal decompression alone,while the observation group was treated with posterior surgical selective fusion and fixation.The treatment effects of the two groups were compared.Results The intraoperative blood loss in the observation group was more than that in the control group,and the operation time was longer than that in the control group(P<0.05).After operation,the Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)scores of the two groups were lower than those before operation,the Japanese Orthopaedic Association Scores(JOA)score was higher than that before operation,and those in the observation group were better than the control group(P<0.05).After operation,the spinal Cobb angle and pelvic inclination angle of the observation group were lower than those of the control group,and the lumbar lordosis angle and sacral inclination angle were higher than those of the control group(P<0.05).Conclusion Posterior surgical selective fusion and fixation has remarkable effect in the treatment of patients with degenerative scoliosis,which can promote the improvement of spinal function.