退行性腰椎侧凸性椎管狭窄诊疗进展
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摘要
随着社会人口的老龄化,退行性腰椎侧凸伴椎管狭窄的发病率迅速上升。患者可出现严重的腰背部疼痛、间歇性跛行和神经根性疼痛及马尾神经综合征等症状,严重者保守治疗效果不明显,需行外科手术治疗。目前,比较公认的手术原则是行椎管减压,重建脊柱的稳定性以及适当矫形,但对其手术方式的选择仍存在争议。本文就退行性腰椎侧凸伴椎管狭窄的发病机制、临床特点、治疗进展等进行综述,以期提高对该病的认识,帮助临床诊断及治疗,改善患者的生活质量。
引文
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[8]SIMMONS ED.Surgical treatment of patients with lumbar spinal stenosis with associated scoliosis[J].Clin Orthop Relat Res,2001,3(384):45-53.
[9]邱勇,王斌,朱锋,等.退变性腰椎侧凸的冠状面失衡分型及对截骨矫形术式选择的意义[J].中华骨科杂志,2009,29(5):418-423.
[10]王岩,张雪松,刘郑生等.侧弯全节段椎弓根螺钉固定治疗退行性脊柱侧凸[J].中国脊柱脊髓杂志,2005,15(4):218-221.
[11]GLASSMAN SD,BRIDWELL K,DIMAR JR,et al.The impact of positive sagittal balance in adult spinal deformity[J].Spine(Phila Pa 1976),2005,30(18):2024-2029.
[12]OUDENHOVEN RC.The role of laminectomy,facet rhizotomy,and epidural steroids[J].Spine(Phila Pa 1976),1979,4(2):145-147.
[13]GUPTA MC.Degenerative scoliosis.Options for surgical management[J].Orthop Clin North Am,2003,34(2):269-279.
[14]DUDKIEWICZ I,COHEN I,HOROWITZ S,et al.Colchicine inhibits heterotopic ossification:experimental study in rabbits[J].Isr Med Assoc J,2005,7(1):31-34.
[15]CHO KJ,SUK SI,PARK SR,et al.Risk factors of sagittal decompensation after long posterior instrumentation and fusion for degenerative lumbar scoliosis[J].Spine(Phila Pa1976),2010,35(17):1595-1601.
[16]SHAPIRO GS,TAIRA G,BOACHIE-ADJEI O.Results of surgical treatment of adult idiopathic scoliosis with low back pain and spinal stenosis:a study of long-term clinical radiographic outcomes[J].Spine(Phila Pa 1976),2003,28(4):358-363.
[17]KATZ JN,LIPSON SJ,CHANG LC,et al.Seven-to 10-year outcome of decompressive surgery for degenerative lumbar spinal stenosis[J].Spine(Phila Pa 1976),1996,21(1):92-98.
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[21]KUKLO TR.Principles for selecting fusion levels in adult spinal deformity with particular attention to lumbar curves and double major curves[J].Spine(Phila Pa 1976),2006,31(19 Suppl):S132-S138.
[22]SHUFFLEBARGER H,SUK SI,MARDJETKO S.Debate:determining the upper instrumented vertebra in the management of adult degenerative scoliosis:stopping at T10 versus L1[J].Spine(Phila Pa 1976),2006,31(19 Suppl):S185-S194.
[23]KIM JH,KIM SS,SUK SI.Incidence of proximal adjacent failure in adult lumbar deformity correction based on proximal fusion level[J].Asian Spine J,2007,1(1):19-26.
[24]HANSDORFER MA,MARDJETKO SM,KNOTT PT,et al.Lumbar spondylolysis and spondylolisthesis in down syndrome:a cross-sectional study at one institution[J].Spine Deform,2013,1(5):382-388.
[25]EDWARDS CC,BRIDWELL KH,PATEL A,et al.Long adult deformity fusions to L5 and the sacrum.A matched cohort analysis[J].Spine(Phila Pa 1976),2004,29(18):1996-2005.
[26]ENGSBERG JR,LENKE LG,UHRICH ML,et al.Prospective comparison of gait and trunk range of motion in adolescents with idiopathic thoracic scoliosis undergoing anterior or posterior spinal fusion[J].Spine(Phila Pa 1976),2003,28(17):1993-2000.
[27]ENGSBERG JR,BRIDWELL KH,REITENBACH AK,et al.Preoperative gait comparisons between adults undergoing long spinal deformity fusion Surgery(thoracic to L4,L5,or sacrum)and controls[J].Spine(Phila Pa 1976),2001,26(18):2020-2028.
[28]KIM YJ,BRIDWELL KH,LENKE LG,et al.Pseudarthrosis in long adult spinal deformity instrumentation and fusion to the sacrum:prevalence and risk factor analysis of 144 cases[J].Spine(Phila Pa 1976),2006,31(20):2329-2336.
[29]KIM YJ,BRIDWELL KH,LENKE LG,et al.Pseudarthrosis in adult spinal deformity following multisegmental instrumentation and arthrodesis[J].J Bone Joint Surg Am,2006,88(4):721-728.
[30]KAFTANDZIEV I,TRPESKI S,FILIPCE V,et al.Operative treatment of degenerative lumbar spine spondylolisthesis[J].Pril(Makedon Akad Nauk Umet Odd Med Nauki),2015,36(1):129-135.
[31]TSUCHIYA K,BRIDWELL KH,KUKLO TR,et al.Minimum 5-year analysis of L5-S1 fusion using sacropelvic fixation(bilateral S1 and iliac screws)for spinal deformity[J].Spine(Phila Pa 1976),2006,31(3):303-308.
[2]BARBAGALLO GM,ALBANESE V,RAICH AL,et al.Lumbar lateral interbody fusion(LLIF):comparative effectiveness and safety versus PLIF/TLIF and predictive factors affecting LLIF outcome[J].Evid Based Spine Care J,2014,5(1):28-37.
[3]腾冲,陈维善,李浩.退变性脊柱侧凸弯度增加因素研究进展[J].国际骨科学杂志,2011,32(6):367-368.
[4]王岩,张雪松,张永刚,等.退行性腰椎侧凸性椎管狭窄神经根受压特点[J].中国医学科学院学报,2005,27(2):170-173.
[5]LOWE T,BERVEN SH,SCHWAB FJ,et al.The SRS classification for adult spinal deformity:building on the King/Moe and Lenke classification systems[J].Spine(Phila Pa 1976),2006,31(19 Suppl):S119-S125.
[6]SCHWAB F,FARCY JP,BRIDWELL K,et al.A clinical impact classification of scoliosis in the adult[J].Spine(Phila Pa1976),2006,31(18):2109-2114.
[7]SIMMONS ED JR,SIMMONS EH.Spinal stenosis with scoliosis[J].Spine(Phila Pa 1976),1992,17(6 Suppl):S117-S120.
[8]SIMMONS ED.Surgical treatment of patients with lumbar spinal stenosis with associated scoliosis[J].Clin Orthop Relat Res,2001,3(384):45-53.
[9]邱勇,王斌,朱锋,等.退变性腰椎侧凸的冠状面失衡分型及对截骨矫形术式选择的意义[J].中华骨科杂志,2009,29(5):418-423.
[10]王岩,张雪松,刘郑生等.侧弯全节段椎弓根螺钉固定治疗退行性脊柱侧凸[J].中国脊柱脊髓杂志,2005,15(4):218-221.
[11]GLASSMAN SD,BRIDWELL K,DIMAR JR,et al.The impact of positive sagittal balance in adult spinal deformity[J].Spine(Phila Pa 1976),2005,30(18):2024-2029.
[12]OUDENHOVEN RC.The role of laminectomy,facet rhizotomy,and epidural steroids[J].Spine(Phila Pa 1976),1979,4(2):145-147.
[13]GUPTA MC.Degenerative scoliosis.Options for surgical management[J].Orthop Clin North Am,2003,34(2):269-279.
[14]DUDKIEWICZ I,COHEN I,HOROWITZ S,et al.Colchicine inhibits heterotopic ossification:experimental study in rabbits[J].Isr Med Assoc J,2005,7(1):31-34.
[15]CHO KJ,SUK SI,PARK SR,et al.Risk factors of sagittal decompensation after long posterior instrumentation and fusion for degenerative lumbar scoliosis[J].Spine(Phila Pa1976),2010,35(17):1595-1601.
[16]SHAPIRO GS,TAIRA G,BOACHIE-ADJEI O.Results of surgical treatment of adult idiopathic scoliosis with low back pain and spinal stenosis:a study of long-term clinical radiographic outcomes[J].Spine(Phila Pa 1976),2003,28(4):358-363.
[17]KATZ JN,LIPSON SJ,CHANG LC,et al.Seven-to 10-year outcome of decompressive surgery for degenerative lumbar spinal stenosis[J].Spine(Phila Pa 1976),1996,21(1):92-98.
[18]FRAZIER DD,LIPSON SJ,FOSSEL AH,et al.Associations between spinal deformity and outcomes after decompression for spinal stenosis[J].Spine(Phila Pa 1976),1997,22(17):2025-2029.
[19]FRAZIER DD,LIPSON SJ,FOSSEL AH,et al.Associations between spinal deformity and outcomes after decompression for spinal stenosis[J].Spine(Phila Pa 1976),1997,22(17):2025-2029.
[20]SILVERS HR,LEWIS PJ,ASCH HL.Decompressive lumbar laminectomy for spinal stenosis[J].J Neurosurg,1993,78(5):695-701.
[21]KUKLO TR.Principles for selecting fusion levels in adult spinal deformity with particular attention to lumbar curves and double major curves[J].Spine(Phila Pa 1976),2006,31(19 Suppl):S132-S138.
[22]SHUFFLEBARGER H,SUK SI,MARDJETKO S.Debate:determining the upper instrumented vertebra in the management of adult degenerative scoliosis:stopping at T10 versus L1[J].Spine(Phila Pa 1976),2006,31(19 Suppl):S185-S194.
[23]KIM JH,KIM SS,SUK SI.Incidence of proximal adjacent failure in adult lumbar deformity correction based on proximal fusion level[J].Asian Spine J,2007,1(1):19-26.
[24]HANSDORFER MA,MARDJETKO SM,KNOTT PT,et al.Lumbar spondylolysis and spondylolisthesis in down syndrome:a cross-sectional study at one institution[J].Spine Deform,2013,1(5):382-388.
[25]EDWARDS CC,BRIDWELL KH,PATEL A,et al.Long adult deformity fusions to L5 and the sacrum.A matched cohort analysis[J].Spine(Phila Pa 1976),2004,29(18):1996-2005.
[26]ENGSBERG JR,LENKE LG,UHRICH ML,et al.Prospective comparison of gait and trunk range of motion in adolescents with idiopathic thoracic scoliosis undergoing anterior or posterior spinal fusion[J].Spine(Phila Pa 1976),2003,28(17):1993-2000.
[27]ENGSBERG JR,BRIDWELL KH,REITENBACH AK,et al.Preoperative gait comparisons between adults undergoing long spinal deformity fusion Surgery(thoracic to L4,L5,or sacrum)and controls[J].Spine(Phila Pa 1976),2001,26(18):2020-2028.
[28]KIM YJ,BRIDWELL KH,LENKE LG,et al.Pseudarthrosis in long adult spinal deformity instrumentation and fusion to the sacrum:prevalence and risk factor analysis of 144 cases[J].Spine(Phila Pa 1976),2006,31(20):2329-2336.
[29]KIM YJ,BRIDWELL KH,LENKE LG,et al.Pseudarthrosis in adult spinal deformity following multisegmental instrumentation and arthrodesis[J].J Bone Joint Surg Am,2006,88(4):721-728.
[30]KAFTANDZIEV I,TRPESKI S,FILIPCE V,et al.Operative treatment of degenerative lumbar spine spondylolisthesis[J].Pril(Makedon Akad Nauk Umet Odd Med Nauki),2015,36(1):129-135.
[31]TSUCHIYA K,BRIDWELL KH,KUKLO TR,et al.Minimum 5-year analysis of L5-S1 fusion using sacropelvic fixation(bilateral S1 and iliac screws)for spinal deformity[J].Spine(Phila Pa 1976),2006,31(3):303-308.