【作者】 马帅；

【导师】 王树人；

【作者基本信息】 黑龙江中医药大学 ， 临床医学， 2008， 硕士

【摘要】 退行性脊柱侧弯是一种特殊类型的脊柱侧弯,是指成年以后新出现的侧弯,而不是被忽视的原有侧弯的进展,除外继发于脊柱椎体器质性病变如肿瘤、创伤骨折、结核等原因引起的侧弯。目前随着社会老龄化的快速进展,退行性脊柱侧弯作为一严重退变的疾病,其发病率有明显增加趋势,是引起老年患者腰痛、下肢痛、间歇性跛行的一重要原因。本文就退行性脊柱侧弯的生理病理学、病因学说、辅助检查及特殊检查、临床表现、治疗等进展做一综述。并着重探讨了后路减压椎弓根系统内固定治疗退行性脊柱侧凸的临床效果。方法:回顾分析2001-2006年45例保守治疗无效的退行性脊柱侧凸病例行后路减压椎弓根系统矫形内固定植骨融合术的临床资料。观察手术后腰背痛和间歇性跛行等临床症状的改善率及手术前后Cobb角及椎体旋转的改善率。结果:术后患者的症状和体征均有明显改善,疼痛改善率95.6%,间歇性跛行改善率93.3%。术前Cobb角平均36.7°(27°-54°),术后Cobb角平均7.8°(0°-18°),改善率78.7%;腰椎前凸角术前平均-17.0°(-37°--15°),术后平均-36.4°(-45°--15°),平均矫正19.4°。随访6-78个月,平均34个月,未见矫正度明显丢失,无断钉及螺钉松动。结论:后路减压椎弓根系统内固定植骨融合治疗退行性腰椎侧凸是能取得比较满意的临床效果和畸形矫正效果的治疗方法。更多还原

【Abstract】 Degenerative scoliosis is a kind of special scoliosis,it happens after you grew older,not the scoliosis that has been ignored.Except the scoliosis which cause by some spine disease such as tumour,traumatic fracture,tuberculosis.With the celerity aging of the society,degenerative scoliosis has become a serious degenerative disease.The incidence of this disease has a obvious increase trend and it is the very important reason of causing lumbago,pain of lower limbs,intermittence claudication.This test summarizes the physiology,pathology,pathogeny,assistant examine and special examine,clinic behave and treatment of degenerative scoliosis.and To investigate clinical results of posterior decompression and pedicle screws fixation of degenerative scoliosis.Method:From January 2001 to December 2006,45 cases with degenerative scoliosis were analyzed for their clinical data retrospectively.After conservation therapy was in vain,those patients had decompression and posterior correction fixation fusion.Cobb angle, lumbar pain relief rate and intermittent claudication relief rate were observed between preoperation and postoperation.Result:All clinical manifestation was improved,pain relief rate was 95.6%,claudication relief rate was 93.3%postoperative.The average preoperative Cobb angle was 36.7°(27°～54°) 7.8°(0°-18°),the average postoperative Cobb angle was 7.8°(0°-18°),the average correcting rate of scoliosis was 78.7%.The average correcting ratio of lumbar lordosis was 88.9%.After an average 34 months(6-78 months) follow up,there vas no correction loss during long follow up,no broken screw and loosening screw.Conclusion:Surgical treatment of degenerative lumbar scoliosis can attain satisfied clinical effect and deformity correction.更多还原