摘要
目的探讨单节段脊柱去松质骨截骨(VCD)与双节段经椎弓根截骨(PSO)矫正强直性脊柱炎后凸畸形的疗效。方法方便选择该院2009年1月—2019年6月收治的60例强直性脊柱炎后凸畸形患者,根据手术方法的不同分成两组,对照组(n=30)采取双节段PSO治疗,观察组(n=30)采取单节段VCD治疗。比较分析两组手术指标、影像学指标、Oswestry功能障碍指数问卷表(ODI)评分、简明健康调查量表(SF-36)评分和并发症发生率。结果观察组手术时间(4.31±0.82)h、术中出血量(985.62±65.17)m L与对照组(6.60±1.23)h、(1 353.28±65.28)mL比较,差异有统计学意义(t=8.485、21.831,P<0.05);观察组各项影像学指标与对照组比较,差异无统计学意义(P>0.05);观察组治疗后ODI(5.85±1.42)分、SF-36(70.03±4.08)分与治疗前(33.12±8.85)分、(53.14±4.05)分比较,差异有统计学意义(t=16.664、16.092,P<0.05);对照组治疗后ODI(5.69±1.51)分、SF-36(69.52±4.15)分与治疗前(33.27±8.96)分、(53.62±4.15)分比较,差异有统计学意义(t=16.625、14.839,P<0.05);对照组不良反应总发生率10.00%与观察组6.67%比较,差异无统计学意义(χ^2=0.218,P>0.05)。结论强直性脊柱炎后凸畸形经单节段VCD治疗后的矫正效果与双节段PSO相似,但前者手术时间更短、术中出血量更少,值得推荐。
Objective To investigate the curative effect of single-segment decancellous osteotomy(VCD) and double-segment transpedicular osteotomy(PSO) to correct ankylosing spondylitis kyphosis. Methods Sixty patients with ankylosing spondylitis and kyphosis admitted to the hospital from January 2009 to June 2019 were convenienty selected and divided into two groups according to different surgical methods. The control group(n=30) was treated with dual-segment PSO and observation group(n=30) received single-segment VCD treatment. The surgical index, imaging index, Oswestry dysfunction index questionnaire(ODI) score, concise Health Inventory(SF-36) score and complication rate were compared and analyzed between the two groups. Results The operation time(4.31±0.82)h and the intraoperative blood loss(985.62±65.17)mL of the observation group were compared with the control group(6.60 ±1.23)h and(1 353.28 ±65.28)mL, the differences were statistically significant(t=8.485, 21.831, P<0.05);compared with the control group, the differences of imaging indexes of the observation group were not statistically significant(P>0.05);the observation group had ODI(5.85±1.42)points, SF-36 after treatment(70.03±4.08)points were compared with(33.12±8.85)points and(53.14±4.05)points before treatment, which was statistically significant(t=16.664, 16.092, P<0.05);control group after treatment ODI(5.69±1.51)points and SF-36(69.52±4.15)points were compared with(33.27 ±8.96) points and(53.62 ±4.15) points before treatment, which were statistically significant(t=16.625, 14.839, P<0.05);the total incidence of adverse reactions in the control group was 10.00% compared with 6.67% in the observation group, the difference was not statistically significant(χ^2=0.218, P >0.05). Conclusion The correction effect of ankylosing spondylitis kyphosis after single-segment VCD treatment is similar to that of double-segment PSO, but the former has shorter operation time and less intraoperative blood loss. It is worth recommending.
作者
张震乾
孔志强
张福兴
柳旭洲
ZHANG Zhen-qian;KONG Zhi-qiang;ZHANG Fu-xing;LIU Xu-zhou(Department of Orthopedics,First People's Hospital of Zhaoqing City,Zhaoqing,Guangdong Province,526000 China)
出处
《中外医疗》
2020年第26期64-66,72,共4页
China & Foreign Medical Treatment
关键词
双节段经椎弓根截骨
强直性脊柱炎
单节段脊柱去松质骨截骨
后凸畸形
Two-level transpedicular osteotomy
Ankylosing spondylitis
Single-level spine osteotomy with cancellous bone removal
Kyphosis
