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| 退变性腰椎侧弯伴骨质疏松的治疗对策 及疗效观察 |
| The treatment strategy and efficacy observation of osteoporosis combined with cataplasia scoliosis of the spine |
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| DOI： |
| 中文关键词: 退变性 腰椎侧弯 骨质疏松 |
| 英文关键词:Degeneration Cataplasia Scoliosis Osteoporosis |
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| 摘要点击次数: 1085 |
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| 中文摘要: |
| 目的探讨退变性腰椎侧弯患者非手术治疗，后路单纯减压，减压卩融合，减压矫形加融合等 治疗方式的治疗效果。方法2000年6月至2010年9月，我院收治退变性腰椎侧弯并进行随访患者 60例，其中非手术治疗10例（均为骨质疏松患者），以腰痛症状为主，神经压迫症状及间歇性跛行较 轻，手术治疗50例（骨质疏松患者40例，平均年龄65岁，Col)b角大于15度，均伴有神经压迫症状或 严重间歇性跛行,保守治疗效果不佳的患者，）采用单纯减压10例，减压加侧后方植骨内固定28例， 矫形加减压加侧后方植骨内固定12例,采用OD I( oswestry disability index))标准⑴，以治疗后改善率 表示对患者治疗前后随访的神经功能和生活能力进行评估。结果对60例患者进行治疗后随访，随 访时间6 ~：36个月，平均加个月。非手术组10例，治疗效果基本满意；手术治疗组50例，其中48例 患者取得满意疗效，另外2例患者术后出现神经牵拉症状,6个月后恢复；非手术治疗组在随访期间 0DI评估较治疗前有改善,手术治疗组术后0DI评估在随访期间较术前也有明显改善，手术组和非手 术组治疗后均取得比较理想效果。结论退变性腰椎侧弯的治疗上全面考虑到患者的年龄、全身妆 况、骨骼质量、症状的程度、神经损害和畸形的进展与否等因素，应该首先考虑非手术治疗，特别是对 于有严重心肺功能不全而不能耐受手术者，更严格把握手术治疗的适应证；手术治疗也应根据患者的 不同症状、体征,影像学资料中椎管狭窄程度、侧凸角度、患者全身情况，以及患者意愿选择不同的手 术方法，选择恰当的治疗方案，才能取得理想的疗效；手术治疗效果是否满意，与减压是否彻底、不稳 . 阶段是否达到稳定，有重要关系，矫形程度对手术治疗效果影响没有决定意义 |
| 英文摘要: |
| Objective To investigate the efficacy of non-surgical treatment, simple back decompression, decompression plus fusion, and decompression-reshaping plus fusion for cataplasia scoliosis of the spine. Methods From June 2000 to September 2010, 60 patients with spinal cataplasia scoliosis were enrolled in our hospital. Among those, 10 patients combined with osteoporosis received non-surgical treatment. These patients mainly suffered with lumbago, combining with mild nerve compression and intermittent claudication symptom. The other 50 patients received surgery (40 patients combined with osteoporosis，whose average age were 65 years old, and the Cobb angle was over 15 degree. They all suffered of nerve compression symptom and severe intermittent claudication, and the effect of conservative therapy was not good) . Ten patients received simple decompression surgery. Twenty-eight patients received decompression and lateroposterial bone graft and internal fixation. Twelve patients received orthotics at the same time. Adopt ODI criterion was used to evaluate their neuro-function and viability before and after the treatment. Results Sixty patients were followed up after the treatment. The follow-up time was 6-36 months, 26 months in |
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