| 成人退行性腰椎侧凸的外科治疗 |
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| 引用本文： | 吴增晖,冯永辉,马向阳,章凯,尹庆水,夏虹.成人退行性腰椎侧凸的外科治疗[J].中国骨科临床与基础研究杂志,2011,3(1):18-21. |
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| 作者姓名： | 吴增晖 冯永辉 马向阳 章凯 尹庆水 夏虹 |
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| 作者单位： | 1. 广州军区广州总医院骨科医院,510010
2. 广州市花都区中医院骨科,510800 |
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| 摘 要： | 目的评估3种外科手术方法治疗成人退行性腰椎侧凸（adult degenerative lumbar scoliosis,ADLS）的临床疗效。方法对1999年7月至2009年7月我院收治的117例ADLS病例根据其临床症状和腰椎畸形程度及特点采取不同的手术方式进行治疗,其中单纯椎管减压术48例,椎管减压＋后路椎弓根钉内固定＋椎体间融合器矫形术62例,极外侧入路椎间融合器融合术（extreme lateral interbody fusion,XLIF）7例。术后及随访期间观察ADLS患者症状及体征的改善、腰椎畸形矫正和椎间植骨融合效果以及并发症的发生情况。结果 66例获得随访,随访时间6～49个月,平均13个月。下肢神经根放射痛缓解率91%,下腰痛缓解率72%。单纯减压术术后下肢麻痛缓解,6例术后12～18个月腰椎畸形开始加重。后路椎弓根钉内固定＋椎体间融合器组和XLIF组能够矫正腰椎的侧凸畸形并重建腰椎的生理前凸,5例术后2年复查发现融合器压塌上位椎体终板。结论单纯神经减压手术可缓解ADLS下肢的根性症状,但对腰椎畸形无矫形作用,术后部分病例腰椎畸形加重。后路椎弓钉内固定＋椎体间融合器组和XLIF组具有矫形和重建生理前凸的作用,是治疗ADLS的较好选择。
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| 关 键 词： | 腰椎 脊柱侧凸 脊柱融合术 内固定器 椎管减压 |
Surgical treatment of adult degenerative lumbar scoliosis |
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| WU Zenghui,FENG Yonghui,MA Xiangyang,ZHANG Kai,YIN Qingshui,XIA Hong.Surgical treatment of adult degenerative lumbar scoliosis[J].Chinese Journal of Clinical and Basic Orthopaedic Research,2011,3(1):18-21. |
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| Authors: | WU Zenghui FENG Yonghui MA Xiangyang ZHANG Kai YIN Qingshui XIA Hong |
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| Institution: | WU Zenghui,FENG Yonghui,MA Xiangyang,ZHANG Kai,YIN Qingshui,XIA Hong.*Department of Orthopaedics,Guangzhou General Hospital of Guangzhou Military Command,Guangzhou,Guangdong 510010,China |
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| Abstract: | Objective To evaluate the clinical efficacy of three different surgical methods for the treatment of adult degenerative lumbar scoliosis(ADLS).Methods From July 1999 to July 2009,117 patients with ADLS in our hospital were performed different surgical methods of simple decompression(48 cases),posterior pedicle screw fixation and interbody fusion(62 cases) as well as extreme lateral correction and interbody fusion(XLIF,7 cases) according to their clinical symptoms and the degree of spinal deformity.Postopera... |
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| Keywords: | Lumbar vertebrae Scoliosis Spinal fusion Internal fixators Spinal canal decompression |
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