Studies of treatment in degenerative lumbar and lower extremity joints disease
- VernacularTitle:腰椎退行性病变合并下肢关节退变性关节病治疗方法探讨
- Author:
Haiying LIU
;
Houshan LV
;
Diange ZHOU
;
Al ET
- Publication Type:Journal Article
- Keywords:
Lumbar verte-b rae;
Spinal stenosis;
Osteoarthritis;
Diagnosis;
Arthroplasty,replacement,hip;
Arthroplasty,replacement,knee
- From:
Chinese Journal of Orthopaedics
1996;0(09):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investiga te the relationship,diagnosis and thera peutic meth ods of degener-ative diseas es of lumbar and lower extremity joints in middle and aged patients.Methods Fr omNovember1997to May2002,50patients suffering from lum bar and hip or knee degenerative diseases concur rently were reviewed.In this group,there w ere14males and36females,ag ing from45to76years old(with an average of 60.5years).In lumbar degenerative disease,13cases were diagnosed as spi nal stenosis of lumbar,and12cases were diagnosed as spinal stenosis of lumb ar accompanied by degenerative spondylolisthesis,25cases spinal stenosis of lumbar accompanied by degenerative scoliosis.While in the degenerative diseases of joints,ostoarthritis was involved in58knee joints of 40cases,10hip joints of 6cases,and both6knee and5hip joints of 4cases.Results Allof the patients were operated upon;anterior lumbar decompression,bone grafting and Z-plate fixation to L1in5cases,posterior decompression and pedicle screws f ixation for insta-bility of spine in45cases.Of 50patients,11cases(1 4joints)underwent arthroscopy or joint replacement prior to lumbar operat ion,with an average interval period of 9.7months(1.5to29months);3ca ses(3knees)underwent joint replacements after lumbar operation,with an ave rage duration of 17.3months(4to36months);3cases(3hip joints)had hi p joint replacement simultaneously with lumbar operation in one setting.For the other33cases no articular operation was performed,and12cases had relief of the symptoms of osteoarthitis after lumbar opera tion;21cases were tre ated with conservative therapy for degenerative dis-eases of joint and allev iated the conditions satis factorily.The average follow-up period was14.2m onths(3to45months).Compared to pre-operation,the average HSS,Harris sco re of joint and JOA score of lumbar were improved by48.2,42.5and14 .3respectively.Conclusion In middle and aged patients with both lumbar and jo int degenerative dis eases,it is very important to make definite diagnosis an d distinguish symp-toms caused by lumbar or joint disease.The major diseas e portions should be treated firstly;if necessary,both joint and lumbar opera tion could be carried out in one surgical setting.
