摘要
目的研究后路减压固定融合术对退行性腰椎侧凸合并椎管狭窄(DLSS)患者的疗效及生活质量的影响。方法回顾性分析2015年1月～2017年1月本院接诊的36例DLSS患者的临床资料,所有患者均采用行后路减压固定融合术治疗。采用腰痛JOA评分系统评估患者临床疗效,采用Oswestry功能障碍指数评分表(ODI)和视觉模拟评分法(VAS)评估患者腰部症状,应用SF-36调查问卷评价患者生活质量。对所有患者进行为期1～1.5年的随访,比较患者术后和末次随访时冠状位Cobb角、腰部症状缓解情况及生活质量。结果 36例行后路减压固定融合术治疗的DLSS患者,平均手术时间(165.83±42.35)min,平均出血量(682.43±42.13)mL,平均住院时间(18.73±3.42)d,平均随访时间(1.12±0.10)年。临床治疗总有效率为91.67%(33/36)。末次随访时,患者的ODI评分、VAS评分和Cobb角均下降,术后和末次随访时的ODI评分、VAS评分和Cobb角比较,差异有统计学意义(P <0.05)。末次随访时,患者的健康情况、生理职能、躯体疼痛、生理功能、情感职能、自我感觉活力、社会功能、精神健康分值均升高,术后和末次随访时的生活质量比较,差异有统计学意义(P <0.05)。结论后路减压固定融合术治疗的DLSS患者临床疗效显著,疼痛症状缓解,腰背功能和生活质量明显提高。
Objective To study the effect of posterior decompression fixation and fusion on the efficacy and quality of life of patients with degenerative lumbar scoliosis complicated with spinal stenosis(DLSS). Methods The clinical data of 36 patients with DLSS who admitted to our hospital from January 2015 to January 2017 were retrospectively analyzed.All patients were treated with posterior decompression fixation and fusion operation.The clinical efficacy of the patients was evaluated by the low back pain JOA scoring system.The Oswestry dysfunction index score(ODI)and visual analog scale(VAS)were used to evaluate the lumbar symptoms of the patients.The SF-36 questionnaire was used to evaluate the quality of life of the patients.All patients were followed up for 1 to 1.5 years.Coronal Cobb angle,relief of lumbar symptoms and quality of life were compared between the patients at the postoperative and last follow-up. Results 36 patients with DLSS who underwent posterior decompression fixation and fusion,the average operation time was(165.83±42.35)min,the mean blood loss was(682.43±42.13)mL,the average hospital stay was(18.73±3.42) days,and the average follow-up time was(1.12±0.10)years.The total effective rate of clinical treatment was 91.67%(33/36).At the last follow-up,the scores of ODI,VAS score and Cobb angle decreased;the differences in ODI score,VAS score and Cobb Angle were statistically significant after surgery and at the last follow-up(P<0.05).At the last follow-up,the health status,physiological function,physical pain,physiological function,emotional function,selfperceived vitality,social function,and mental health scores of the patients were all increased,and the postoperative quality of life was significantly different from that at the last follow-up(P<0.05). Conclusion DLSS patients treated by posterior decompression,fixation and fusion have significant clinical efficacy,relieve pain symptoms,and significantly improve lumbar function and quality of life.
作者
蔺福辉
LIN Fuhui(Department of Orthopaedics,Pingle Orthopaedic Hospital,Shenzhen 518000,China)
出处
《中国医药科学》
2019年第5期230-232,236,共4页
China Medicine And Pharmacy
关键词
退行性腰椎侧凸
椎管狭窄
后路减压固定融合术
功能障碍指数
生活质量
Degenerative lumbar scoliosis
Spinal stenosis
Posterior decompression fixation and fusion
Disability index
Quality of life
