Clinical Efficacy of Transpedicular Fixation in the Treatment of Degenerative Scoliosis Complicated with Spinal Stenosis
10.11969/j.issn.1673-548X.2024.08.029
- VernacularTitle:经椎弓根固定治疗退行性脊柱侧凸合并椎管狭窄的临床疗效研究
- Author:
Jianwei XI
1
;
Lei LIU
;
Guangpu LIU
Author Information
1. 221009 徐州医科大学徐州临床学院
- Keywords:
Degenerative scoliosis;
Spinal stenosis;
Decompression,surgical;
Spinal fusion
- From:
Journal of Medical Research
2024;53(8):150-154
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical efficacy of transpedicle fixation in the treatment of degenerative scoliosis(DS)combined with spinal stenosis(SS).Methods The clinical data of 110 patients with DS and SS who were treated with decompression combined with posterior pedicle fixation from January 2018 to December 2021 were retrospectively analyzed.According to the number of fused vertebrae,the patients were divided into long-segment group(n=57,fixed segments＞3)and short-segment group(n=53,fixed segments ≤3).The perioperative,follow-up and imaging data were compared between the two groups.Results There were no significant differences in age,gender,course of disease,the direction of main curvature and prevalence of osteoporosis between the two groups(P＞0.05).The length of hospital stay,operative time and intraoperative blood loss in the long-segment group were longer than those in the short-segment group(P＜0.05).Compared with pre-operation,the visual analogue scale(VAS)score of lumbago,the VAS score of melosalgia and Oswestry disability index(ODI)were decreased in both groups at the last follow-up.The scores of the long-segment group were lower than those of the short-segment group at the last follow-up(P＜0.05).Compared with pre-opera-tion,the Cobb angle,pelvic title(PT)and sagittal vertical axis(SVA)were decreased and LL was increased in both groups at the last follow-up(P＜0.05).The Cobb angle,LL,PT and SVA were smaller and the LL was larger in the long-segment group than those in the short-segment group at the last follow-up(P＜0.05).At the last follow-up,bone fusion was achieved in the interbody fusion are-a in both groups.The incidence of complications in the long-segment group and the short-segment group was 28.07％(16/57)and 11.32％(6/53),respectively,with statistically significant differences(x2=4.815,P=0.028).Conclusion In the case of appropri-ate surgical methods,transpedicular fixation for DS combined with SS has achieved good clinical effect.Long-segmental fixation in re-store spinal balance and improve the clinical symptoms effect is better,short-segmental fixation has less trauma,shorter operation time and lower complication incidence.The surgical plan should be selected after the comprehensive evaluation of the patients.
