椎间孔镜松解术联合不对称截骨术对僵硬性退行性脊柱侧凸的疗效。

IF 2.8 3区 医学 Q1 ORTHOPEDICS Journal of Orthopaedic Surgery and Research Pub Date : 2024-11-13 DOI:10.1186/s13018-024-05133-9
Xueneng Yang, Ruijuan Li, Qiangqiang Qi, JunFei Liu, Xiaoyu Zheng, Jun Shu
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引用次数: 0

摘要

目的:本研究旨在评估通过椎间孔镜松解术和不对称1、2级截骨术联合治疗硬性退行性脊柱侧凸患者,恢复椎间平衡的临床疗效和安全性:收集2015年至2022年间我科硬性退行性脊柱侧凸患者的临床和影像学资料。研究共纳入 60 例患者,其中男性 20 例,女性 40 例,平均随访时间为 30.7 个月。记录的数据包括手术时间、失血量、固定节段数量、住院时间、并发症、临床评分和影像学参数:矢状面垂直轴从术前的 4.28 ± 1.48 厘米改善到术后的 2.90 ± 1.18 厘米,冠状面垂直轴从术前的 3.29 ± 1.72 厘米改善到术后的 1.12 ± 0.62 厘米。术前冠状面 Cobb 角为 30.85 ± 7.33°,术后改善为 4.14 ± 3.06°。此外,腰椎前凸从术前的 24.50 ± 17.24°增加到术后的 30.35 ± 6.11°。腰痛和腿痛的 VAS 评分、ODI 评分和 JOA 评分均有不同程度的改善:结论:椎间孔松解术联合非对称1级和2级截骨术恢复椎间平衡,可明显改善硬性退行性脊柱侧凸患者的脊柱畸形和术后功能评分。
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Efficacy of intervertebral release combined with asymmetric osteotomy in rigid degenerative scoliosis.

Purpose: The aim of this study is to evaluate the clinical efficacy and safety of treating patients with rigid degenerative scoliosis by restoring intervertebral balance through a combination of interbody release and asymmetric grade 1 and 2 osteotomy.

Method: The medical collected clinical and radiographic data of patients with rigid degenerative scoliosis from our department between 2015 and 2022. A total of 60 patients were included in the study, comprising 20 males and 40 females, with an average follow-up period of 30.7 months. Data recorded included surgery duration, blood loss, number of fixed segments, hospital stay, complications, clinical scores, and radiographic parameters.

Results: The sagittal vertical axis improved from 4.28 ± 1.48 cm preoperatively to 2.90 ± 1.18 cm postoperatively, while the coronal vertical axis improved from 3.29 ± 1.72 cm preoperatively to 1.12 ± 0.62 cm postoperatively. The preoperative coronal Cobb angle was 30.85 ± 7.33°, which improved to 4.14 ± 3.06°postoperatively. Additionally, lumbar lordosis increased from 24.50 ± 17.24°preoperatively to 30.35 ± 6.11°postoperatively. VAS scores for back pain and leg pain, ODI scores, and JOA scores showed varying degrees of improvement.

Conclusion: Interbody release combined with asymmetric Grade 1 and 2 osteotomy to restore intervertebral balance significantly improves spinal deformity and postoperative functional scores in patients with rigid degenerative scoliosis.

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来源期刊
CiteScore
4.10
自引率
7.70%
发文量
494
审稿时长
>12 weeks
期刊介绍: Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues. Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications. JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.
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