腰椎后路减压固定融合术治疗退变性腰椎侧凸症

目的：探讨腰椎后路减压、固定融合术治疗症状严重的退变性腰椎侧凸患者的临床效果。方法：同顾性分析2001年1月～2005年10月间行腰椎后路减压矫形内固定植骨融合术治疗的36例退变性腰椎侧凸患者的f临床资料。用日本骨科学会（JOA）29分法对患者术前和随访时的神经功能和生活能力进行评分。计算改善率，并对病程、年龄、术后Cobb角等因素与随访改善率的关系进行统计学分析。结果：术中发生硬膜撕裂1例．修补后未出现脑脊液漏。术后3例出现下肢神经损害症状加重，相应处理后1例完全恢复正常，1例部分恢复，1例无恢复。2例术后切口液化坏死，经清创置管冲洗，切口延迟愈合。无其他严重并发症及闹手术期死亡。27例获得随访，随访时间5～57个月，平均33.2个月，术前JOA评分平均13.3分，末次随访时平均27．0分．改善率平均为87．4％。改善率与病程、年龄、术后Cobb角等因素相关关系不显著。结论：腰椎后路手术治疗退变性腰椎侧凸安全有效，病程、年龄等对术后远期改善率无明显影响。

Posterior decompression and fusion for degenerative lumbar scoliosis

Objective:To explore the effect of posterior decompression and fusion for degenerative lumbar scoliosis with severe symptoms.Method:From January 2001 to October 2005,36 cases with degenerative lumbar scoliosis undergoing the treatment of posterior decompression,correction and fusion were reviewed retrospectively.The neurological functions and self-care abilities of each patients were evaluated by JOA scoring system preoperatively and at follow-up period.The relationship between improvement rate and the course of disease,age,postoperative Cobb angle correction at follow-up was analyzed statistically.Result:There was 1 case of dural tear,no CSF leakage was noted after surgical repairing.Of 3 cases sequenced with deteriorated neurological function after operation,1 case recovered completely after proper treatment,1 case got partial recovery,while the other 1 case had no recovery.No other severe complication such as pereoperational death was noted.27 cases were followed-up for an average of 33.2 months(range,5-57 months).The average JOA score was 13.3 for preoperation and 27.0 for the latest follow-up with the average improve rate of 87.4%.The statistic analysis showed there was no relationship between the improvement rate and the course of disease,age,postoperative Cobb angle correction.Conclusion:Degenerative lumbar scoliosis can be treated effectively and safely by lumbar posterior decompression and fusion.The course of disease and the age of patients have no effect on the improvement rate.