退变性腰椎侧凸的外科治疗

目的探讨退变性腰椎侧凸的特点、诊断与治疗。方法2001年7月至2004年1月手术治疗退变性脊柱侧凸患者15例,行后路彻底椎板减压、椎弓根钉棒矫形固定,椎间融合器融合12例,后外侧植骨融合3例,回顾性分析其临床特点、手术方法与效果。结果术后侧凸平均矫正率为42.8%,腰腿痛均消失,下肢麻木等症状减轻,随访6~36个月,植骨融合良好,无融合器移位,矫正度数与椎间隙高度无丢失。结论成人退变性腰椎侧凸发病年龄大,多合并腰椎管狭窄、失稳等,腰腿痛原因复杂,治疗的主要目的是彻底减压,通过矫形使脊柱重新获得稳定,椎弓根钉棒固定及椎间融合是有效的治疗方法。

The Surgical Treatment of Degenerative Lumbar Scoliosis

Objective To discuss the characteristic,diagnosis and treatment of degenerative lumbar scoliosis.Methods From Jul 2001 to Jan 2004,15 patients suffered with degenerative lumbar scoliosis were treated by decompression and correction instrumented with pedicle screws through posterior procedure,and lumbar fusions were undergone at the same time.Of them,12 cases were fused with intervertebral cages,and the other 3 cases fused by post-lateral bone grafting.The clinical characteristics,therapy strategies and effects were analyzed retrospectively.Results Postoperatively,the average correcting rate of scoliosis was 42.8%,their lumbago and sciatica were all relieved,and the leg numbness were also alleviated.After mean follow-up of 36 months,all cases obtained solid fusion,and there were no lose of correction and height of disc spaces.Conclusion Adult degenerative lumbar scoliosis often combined with lumbar stenosis and instability,and the causes of pain are complicated.The therapeutic purpose is to decompress thoroughly,correct the deformity,recover the stability of the spine. Fixation with pedicle screws combined with interbody fusion is an effective treatment.