| Objective Explore reasonable treatment scheme, in both the effect of operation at the same time and minimize risks and complications.Methods Select 21 patients with degenerative scoliosis in the second hospital of dalian medical university spine ward in March 2013 to December 2014, using posterior decompression, bone graft and pedicle screw system fixation.For 14 patients with Cobb Angle less than 20° using short segmental pedicle screw rod system, intervertebral fusion was conducted in the intervertebral space which has the biggest Coob angle. The same performance was conducted in the two biggest scoliosis intervertebral space in 7 patients with Cobb angle more than 20°,long segmental pedicle screw rod system was manipulated at the same time. Intraoperative decompression, thoroughly remove nerve root compression.Taken anterior-posterior and lateral plain image of spine, measuring postoperative Cobb Angle, lumbar lordosis Angle, JOA and VAS score. For patients with postoperative JOA score, visual analogue scale all choose 1 week after surgery.Outpatient clinic visits, regularly review the positive side of the spine, to observe the bone graft fusion, with or without internal fixation failure, and postoperative recovery of patients.Choose Cobb Angle contrast, JOA score before and after operation, visual analog pain score three indicators to evaluate operation effect, and the results were analyzed.Results Successful results are received in all the 21 cases, death and other major accident did not happen. Postoperative symptoms of all patients were improved, the quality of life are improved, and patients with intermittent claudication symptoms are effectively relieve, different levels of symptom relief lumbago, nerve root stimulation such as radioactive pain symptoms was significantly reduced, 4 cases of patients with postoperative legacy involved nerve root dominate the numbness, and the total discomfort was alleviated. 2 to 9 weeks after the numbness symptoms disappeared gradually, symptom recurrence was not found during the follow-up period, all patients were satisfied with the surgical effect. No surgery incision infection was found in all the cases, 1 case with fat liquefaction of incision in diabetes patients, after regular dressing change the case was healedl.2 cases of bone cement to strengthen does not appear in patients with bone cement leakage phenomenon. Only 1 case suffered from dura mater rupture and manipulated tight suture and no postoperative cerebrospinal fluid leakage was found, no lower cranial pressure symptoms such as headache, no infection happens. 2 cases came up with postoperative symptoms of urinary system infection was cured after regular antibiotic treatment. No pulmonary infection and complications such as deep vein thrombosis were found in all the cases.1 patients came up with fusion of fixed upper adjacent segment 14 months after operation. But no subjective symptoms were found. Comparing with that before operation, the average correction rates of the patient’s Cobb Angle is 77.71%, coronary malformations are largely corrected.JOA and VAS score compared with that of preoperative were significantly improved.Conclusion Posterior decompression fusion and internal fixation is an effective way for treatment of degenerative scoliosis.For patients with Cobb Angle is less than 20°, choose short segmental fixation, intervertebral fusion was conducted in the intervertebral space which has the biggest Coob angle. As to the same performance was conducted in the two biggest scoliosis intervertebral space in 7 patients with Cobb angle more than 20°,long segmental pedicle screw rod system was manipulated at the same time. Our treatment can relieve clinical symptoms significantly, largely rectify deformity, restore the spinal balance, guarantee the long-term curative effect, and decrease the surgical trauma, as well as the possibilities of surgical risks, etc. |
PDF Full Text Request