一期后路矫形治疗脊柱侧凸合并无症状脊髓栓系患者的临床研究
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摘要
目的探讨脊柱侧凸合并无症状脊髓栓系患者采用一期后路矫形治疗的临床效果。方法 20例脊柱侧凸合并无症状脊髓栓系患者,均行一期后路矫形治疗,观察分析患者矫形效果及治疗前、后SRS-22评分和改良日本骨科学会评分。结果术后1、6个月患者冠状面Cobb角[(24.56±5.89)°、(22.46±4.78)°]明显小于治疗前[(57.46±11.68)°](P<0.05),术后1个月与术后6个月比较差异无统计学意义(P>0.05);治疗后患者活动能力评分[(21.22±1.97)分]、疼痛程度评分[(21.68±1.68)分]、自我形象评分[(19.26±2.64)分]、心理状况评分[(20.18±1.78)分]和SRS-22总评分[(85.69±4.97)分]均高于治疗前[(17.64±2.64)、(19.89±1.64)、(14.24±2.46)、(15.16±2.34)、(66.89±3.97)分](P<0.05);治疗后患者主观症状评分[(8.92±1.24)分]、客观体征评分[(5.23±0.44)分]、日常能力评分[(12.68±1.22)分]和改良日本骨科学会总评分[(25.68±1.82)分]均明显高于治疗前[(6.26±1.26)、(4.26±0.68)、(10.23±1.64)、(20.68±1.98)分](P<0.05)。结论一期后路矫形治疗脊柱侧凸合并无症状脊髓栓系患者脊柱矫正效果好,并对患者生活质量与身体机能起有效改善作用。
Objective To study the clinical value of one-stage posterior correction to the treatment of scoliosis in patients with asymptomatic tethered cord. Methods Twenty patients with scoliosis complicated with asymptomatic tethered cord underwent one-stage posterior correction. The orthopedic outcome, SRS-22 score and modified Japanese Orthopedic Association score were compared before and after treatment. Results The coronal Cobb angle was significantly smaller 1 and 6 months after operation((24.56±5.89)°,(22.46±4.78)°) than that before operation((57.46±11.68)°)(P<0.05), and showed no significant difference between 1 and 6 months after operation(P>0.05). After treatment, the patients' activity(21.22±1.97), pain degree score(21.68±1.68), self-image score(19.26±2.64), psychologic score(20.18±1.78) and SRS-22 score(85.69±4.97) higher after operation were significantly than those before treatment(17.64±2.64, 19.89±1.64, 14.24±2.46, 15.16±2.34, 66.89±3.97)(P<0.05). The subjective symptom score(8.92±1.24), objective symptom score(5.23±0.44), daily activity score(12.68±1.22) and modified Japanese Orthopedic Association score(25.68±1.82) after operation were significantly higher than those before operation(6.26±1.26, 4.26±0.68, 10.23±1.64, 20.68±1.98)(P<0.05). Conclusion One-stage posterior correction is effective for scoliosis complicated with asymptomatic tethered cord, and can improve the quality of life and physical function of the patients.
Objective To study the clinical value of one-stage posterior correction to the treatment of scoliosis in patients with asymptomatic tethered cord. Methods Twenty patients with scoliosis complicated with asymptomatic tethered cord underwent one-stage posterior correction. The orthopedic outcome, SRS-22 score and modified Japanese Orthopedic Association score were compared before and after treatment. Results The coronal Cobb angle was significantly smaller 1 and 6 months after operation((24.56±5.89)°,(22.46±4.78)°) than that before operation((57.46±11.68)°)(P<0.05), and showed no significant difference between 1 and 6 months after operation(P>0.05). After treatment, the patients' activity(21.22±1.97), pain degree score(21.68±1.68), self-image score(19.26±2.64), psychologic score(20.18±1.78) and SRS-22 score(85.69±4.97) higher after operation were significantly than those before treatment(17.64±2.64, 19.89±1.64, 14.24±2.46, 15.16±2.34, 66.89±3.97)(P<0.05). The subjective symptom score(8.92±1.24), objective symptom score(5.23±0.44), daily activity score(12.68±1.22) and modified Japanese Orthopedic Association score(25.68±1.82) after operation were significantly higher than those before operation(6.26±1.26, 4.26±0.68, 10.23±1.64, 20.68±1.98)(P<0.05). Conclusion One-stage posterior correction is effective for scoliosis complicated with asymptomatic tethered cord, and can improve the quality of life and physical function of the patients.
引文
[1] 张宏其,周振海,王龙杰,等.一期后路矫形治疗脊柱侧弯合并无症状脊髓栓系患者的临床研究[J].中国矫形外科杂志,2017,25(3):193-198.
[2] 王涛,林伟,史铁钧,等.142例脊髓纵裂合并骨性分隔患者的临床诊疗探讨[J].中华神经外科疾病研究杂志,2017,16(5):397-401.
[3] 王凯,吴浩,菅凤增.脊柱侧弯合并椎管内病变的一期手术治疗[J].中国现代神经疾病杂志,2017,17(9):116-118.
[4] 曹云,羊东,彭五四,等.后路截骨联合椎弓根内固定矫形治疗僵硬性脊柱侧后凸畸形[J].临床骨科杂志,2016,19(4):391-394.
[5] 刘红菊,虞雪融,黄宇光.围手术期FFP输注对脊柱侧弯后路矫形术患者预后的影响[J].中国输血杂志,2016,29(5):492-494.
[6] 肖振芹,李政军,刘海龙,等.64层螺旋CT在先天性脊柱侧弯矫形术前的应用价值[J].河北医药,2014,10(1):89-90.
[7] 耿立阳,叶金铎,钟伟弘,等.脊柱侧弯矫形对漏斗胸胸廓变形影响的研究[J].生物医学工程与临床,2017,33(3):6-10.
[8] 杨彬,王小刚,王亚寒,等.附加伤椎经椎弓根螺钉内固定术结合术中CT在合并神经症状的胸腰椎骨折手术中的应用[J].中华实用诊断与治疗杂志,2018,32(5):73-75.
[9] 秦丹,乔敏霞,王萍,等.脊髓栓系综合征MRI表现[J].中华实用诊断与治疗杂志,2014,28(3):286-287.
[2] 王涛,林伟,史铁钧,等.142例脊髓纵裂合并骨性分隔患者的临床诊疗探讨[J].中华神经外科疾病研究杂志,2017,16(5):397-401.
[3] 王凯,吴浩,菅凤增.脊柱侧弯合并椎管内病变的一期手术治疗[J].中国现代神经疾病杂志,2017,17(9):116-118.
[4] 曹云,羊东,彭五四,等.后路截骨联合椎弓根内固定矫形治疗僵硬性脊柱侧后凸畸形[J].临床骨科杂志,2016,19(4):391-394.
[5] 刘红菊,虞雪融,黄宇光.围手术期FFP输注对脊柱侧弯后路矫形术患者预后的影响[J].中国输血杂志,2016,29(5):492-494.
[6] 肖振芹,李政军,刘海龙,等.64层螺旋CT在先天性脊柱侧弯矫形术前的应用价值[J].河北医药,2014,10(1):89-90.
[7] 耿立阳,叶金铎,钟伟弘,等.脊柱侧弯矫形对漏斗胸胸廓变形影响的研究[J].生物医学工程与临床,2017,33(3):6-10.
[8] 杨彬,王小刚,王亚寒,等.附加伤椎经椎弓根螺钉内固定术结合术中CT在合并神经症状的胸腰椎骨折手术中的应用[J].中华实用诊断与治疗杂志,2018,32(5):73-75.
[9] 秦丹,乔敏霞,王萍,等.脊髓栓系综合征MRI表现[J].中华实用诊断与治疗杂志,2014,28(3):286-287.