张鲁东　易志坚解放军第一四八医院骨科二区，山东淄博　255300

全节段经椎弓根螺纹钉固定融合术治疗老年脊柱侧凸性腰椎管狭窄症的疗效观察

张鲁东易志坚
解放军第一四八医院骨科二区，山东淄博255300

目的 探讨全节段经椎弓根螺纹钉固定融合术在老年脊柱侧凸性腰椎管狭窄症患者中的应用效果。方法收集我院2012年5月～2014年1月入院的60例脊柱侧凸性腰椎管狭窄症老年患者并随机分为两组，对照组予常规腰椎减压+植骨融合内固定术治疗，实验组采用常规腰椎减压+全节段经椎弓根螺纹钉固定融合术治疗，比较两组患者治疗前后腰部疼痛与下肢功能、总体治疗效果与并发症等。结果 实验组患者治疗后JOA评分（12.05±2.51）分，组间比较显著高于对照组（10.21±2.07）分，实验组ODI指数（20.17±5.35）显著低于对照组（24.26± 5.06）；实验组整体治疗效果明显优于对照组，实验组总体并发症发生率（16.67%）明显低于对照组（40.00%），差异具有统计学意义（P＜0.05）。结论全节段经椎弓根螺纹钉固定融合术在脊柱侧凸性腰椎管狭窄症老年患者中的应用效果显著。

脊柱侧凸；腰椎管狭窄；全节段经椎弓根螺纹钉固定融合；并发症

［Abstract］Objective To investigate the effect of segmental pedicle screw fixation and fusion application in treatment of elderly patients with lumbar spinal stenosis of the scoliosis.Methods From May 2012 to January 2014，60 cases with lumbar spinal stenosis of the scoliosis in our hospital were randomly divided into two groups，control group of patients were treated with conventional lumbar decompression and fusion and internal fixation，the experimental group of patients were treated with conventional lumbar decompression segmental pedicle screw fixation and fusion treatment，the back pain and lower limb function before and after treatment，the overall treatment effect and other complications of the two groups were compared.Results The JOA score in experimental group was（12.05±2.51），higher than（10.21±2.07）in control group，ODI index in experimental group was（20.17±5.35），was significantly lower than the control group （24.26±5.06）；the overall treatment effect in experimental group was better than the control group；the overall complication rate（16.67%）in experimental group was significantly lower than the control group（40.00%）（P＜0.05）.Conclusion Segmental pedicle screw fixation and fusion in the lumbar canal stenosis in elderly patients with scoliosis of the application results are obvious.

［Key words］Scoliosis；Spinal stenosis；Segmental pedicle screw fixation and fusion；Complication

脊柱侧凸性腰椎管狭窄症（SSS）泛指在脊柱以双肩不等高为特点的三维畸形的基础上合并的椎管径线缩短，使硬膜囊与神经根等部位受压而产生的腰腿疼痛与神经功能综合征，是老年骨科常见病，在临床上颇受重视［1，2］。针对该病的治疗，临床上则首选手术方案，但术式的选择一直是临床上一大难题［3，4］，故而为讨论全节段经椎弓根螺纹钉固定融合术在脊柱侧凸性腰椎管狭窄症老年患者中的应用效果，现报道如下。……