| 退行性腰椎侧弯合并腰椎管狭窄的手术治疗 |
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Received:July 25, 2008
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| 作者 | Author | 单位 | Unit | E-Mail |
| 毛兆光 |
MAO Zhao-guang |
江山市人民医院骨二科，浙江 江山 324100 |
Department of Orthopaedics,the Peoples Hospital of Jiangshan,Jiangshan 324100,Zhejiang,China |
mzg0906@126.com |
| 巫庆新 |
WU Qing-xin |
江山市人民医院骨二科，浙江 江山 324100 |
Department of Orthopaedics,the Peoples Hospital of Jiangshan,Jiangshan 324100,Zhejiang,China |
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| 祝介明 |
ZHU Jie-ming |
江山市人民医院骨二科，浙江 江山 324100 |
Department of Orthopaedics,the Peoples Hospital of Jiangshan,Jiangshan 324100,Zhejiang,China |
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| 李淳德 |
LI Chun-de |
北京大学第一医院骨科 |
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| 朱天岳 |
ZHU Tian-yue |
北京大学第一医院骨科 |
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| 期刊信息：《中国骨伤》2008年21卷，第11期，第860-862页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的：探讨退行性腰椎侧弯合并腰椎管狭窄的手术方法及其临床效果。
方法：回顾性分析32 例适应证患者经后路椎间融合器或后外侧融合结合椎弓根系统固定的治疗效果。男18例，女14 例；年龄49～75岁，平均56.8岁；腰椎前凸基本未变者15 例，腰椎侧弯伴有椎体半脱位和腰前凸丢失严重者17 例。术后测量退变性脊柱侧弯的矫正效果、观察腰腿疼痛改善率、并发症和随访结果。
结果：全部病例获得随访，时间6～49 个月，平均13 个月。术后平均侧弯矫正率为58.0 % ,疼痛改善率为(80.2±5.8) % ( P<0.05),硬脊膜囊撕裂2 例，神经根损伤2 例，假关节形成1 例。随访期间矫正度数、椎间隙高度无丢失，融合器无移位，内固定物融合良好，植骨融合率96.9%.
结论：后路椎间融合器或后外侧融合结合经椎弓根系统是治疗退变性脊柱侧弯合并腰椎管狭窄的一种安全有效的方法。手术应重视矫正腰椎侧弯畸形、改善腰椎力学平衡，以提高术后中远期临床疗效。 |
| [关键词]:脊柱侧弯 椎管狭窄 脊柱融合术 |
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| Surgical treatment for degenerative lumbar scoliosis associated with spinal stenosis |
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Abstract:
Objective: To study surgical techniques for degenerative lumbar scoliosis associated with lumbar stenosis and evaluate their clinical significane.
Methods: Thirty-two patients with degenerative lumbar scoliosis associated with spinal stenosis were treated by techniques of posterior lumbar interbody fusion or posterolateral fusion and pedicle screws. There were 18 male and 14 female with 56.8 years old on the average(ranging from 49 to 75 years). There were no evident change of lumber lordosis in 15 cases,and lumber lordosis were obvious loss associated with lumbar subluxation in 17 cases. The correcting,the improvement of back and leg pain,complications and followed-up results were analyzed retrospectively.
Results: Thirty-two cases were followed-up for 6 to 39 months(the average time of 13 months). The average correction rate of scoliosis was 58.0% and the rate of pain relief was(80.2±5.8)% . There were two cases of dura sac laceration,two cases of nerve roots injury and a case of pseudoarthritis. During followed-up,correction rate and height of disc spaces were not lost. Shift of interbody cages were no displaced;all the internal fixation got well fusion and the rate of fusion for the bone graft was 96.9%.
Conclusion: Posterior pedicle screws combined with interbody fusion or posterolateral fusion is a safe and effective surgical treatment for degenerative lumbar scoliosis associated with lumbar stenosis. |
| KEYWORDS:Scoliosis Spinal stenosis Spinal fusion |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 毛兆光,巫庆新,祝介明,李淳德,朱天岳.退行性腰椎侧弯合并腰椎管狭窄的手术治疗[J].中国骨伤,2008,21(11):860~862 |
| 英文格式: | MAO Zhao-guang,WU Qing-xin,ZHU Jie-ming,LI Chun-de,ZHU Tian-yue.Surgical treatment for degenerative lumbar scoliosis associated with spinal stenosis[J].zhongguo gu shang / China J Orthop Trauma ,2008,21(11):860~862 |
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