腰椎后路节段减压植骨内固定治疗退变性腰椎侧凸

目的评价腰椎后路节段减压植骨内固定治疗退变性腰椎侧凸的临床效果。方法自2009年9月-2010年12月采用腰椎后路节段减压植骨内固定手术治疗退变性腰椎侧凸53例。根据JOA评分标准评估患者术后神经功能的恢复情况，通过X线片观察腰椎前凸角、侧凸角的改善情况。结果随访3-12个月，平均随访时间8个月。末次随访JOA评分改善率平均为85．2％。优34例，良14例，可5例，优良率90．6％。腰椎侧凸Cobb’S角由术前的（30．5．4-6．1）。矫正到末次随访的（12．3±4．1）；腰椎前凸角由术前的（15.2±4．6）。矫正到末次随访的（32．1±7．3）。无矫正角度明显丢失及内固定物失效。结论腰椎后路节段减压植骨内固定手术是治疗退变性腰椎侧凸的一种有效方法。

Posterior lumbar segmental decompression and bone graft for the treatment of degenerative lumbar scoliosis

evaluate the clinical efficacy of posterior lumbar segmental decompression and bone graft for the treatment of degenerative lumbar scoliosis （DLS）. Methods From September 2009 to December 2010, 53 patients with DLS were treated by posterior lumbar segmental decompression and bone graft. Preoperative and postoperative functional evaluation were graded with JOA scoring system and the improvement rate was calculated. The angles of lumbar lordosis and scoliosis were measured according to radiographic images as well. Results All cases were followedup from 3 to 12 months （average, 8 months）, the improvement rate of JOA scores at latest followup was 85.2%. There were excellent in 34 cases, good in 14 cases, fair in 5 cases, with the excellentgood rate of 90.6%. Cobb＇s angle of lumbar scoliosis was corrected from （30.5 ±6.1）~ at preoperation to （12.3 ±4.1）~at postoperation; angle of lumbar lordosis was corrected from （15.2 ± 4.6）~ at preoperation to （32.1 ± 7.3）~at postoperation. The correction degree was no obviously lost and no internal fixation failure occurred. Conclusion Posterior lumbar segmental decompression and bone graft is effective surgical method for DLS patients.