神经根管扩大减压椎弓根螺钉内固定椎间融合术治疗腰椎退变性侧弯的效果

Clinical effect of expanded decompression of nerve root canal plus pedicle screw internal fixation and interbody fusion on lumbar degenerative scoliosis

目的观察腰椎退变性侧弯患者采用神经根管扩大减压椎弓根螺钉内固定椎间融合术治疗的疗效。方法选择2019年8月至2020年8月收治的腰椎退变性侧弯患者65例,随机数字表法分为对照组和试验组。对照组33例行单纯扩大开窗潜式减压术治疗,试验组32例行神经根管扩大减压椎弓根螺钉内固定椎间融合术。对比2组患者手术情况与临床疗效、并发症情况。结果试验组术后VAS评分低于对照组(P<0.05);试验组术后Oswestry评分低于对照组(P<0.05);试验组在影像学指标(后凸角以及伤椎前缘、中线、后缘高度)优于对照组(P<0.05)。试验组并发症率显著低于对照组,试验组治疗后的症状改善评分显著高于对照组(P<0.05);试验组术后6个月、术后12个月椎间隙高度高于对照组(P<0.05)。结论神经根管扩大减压术可较好改善腰椎退变性侧弯患者的临床症状,缓解患者疼痛,改善患者侧弯状况,并发症少,远期效果更优。

Objective To observe the clinical efficacy of expanded decompression of nerve root canal plus pedicle screw internal fixation and interbody fusion on lumbar degenerative scoliosis.Methods A total of 65 patients with lumbar degenerative scoliosis admitted to our hospital from August 2019 to August 2020 were randomly divided into two groups.Thirty-three patients in the control group were treated with simple expanded window decompression,and 32 patients in the experimental group were treated with expanded nerve root canal decompression plus pedicle screw internal fixation and interbody fusion.The operation condition,clinical efficacy and complications were compared between groups.Results The postoperative scores of the Visual Analogue Scale(VAS)and the Oswestry Disablity Index(ODI)in the experimental group were significantly lower than those in the control group(all P<0.05).Four image indexes were significantly better in the experimental group than those in the control group(P<0.05).The incidence of complications was significantly lower in the experimental group than that in the control group(P<0.05).The symptom improvement score in the experimental group was significantly higher than that in the control group(P<0.05).The intervertebral space height at 6 and 12 months postoperative was significantly higher in the experimental group than that in the control group(P<0.05).Conclusion Expanded decompression of nerve root canal can better improve the clinical symptoms of patients with lumbar degenerative scoliosis,relieve the pain,and alleviate the scoliosis with less complications and better long-term effect.