Clinical Analysis And Complications Of Post - Operative Treatment Of Post - Operative ADS In Different Periods

Objective: Retrospective analysis in January 2013 to May 2016 diagnosed with ADS and undergo surgery, preoperative and postoperative data complete different periods in 55 patients, explore the posterior segmental spinal canal decompression and vertebral body more between fusion , orthopaedic pedicle screw fixation treatment of ADS in different periods of clinical efficacy and related complications after surgery. Methods: With visual analogue scale (VAS), the Japanese orthopaedic association (JOA) score and preoperative and postoperative radiographic parameters measurement of ADS in patients with preoperative and postoperative clinical characteristics in different periods, clinical, alleviate the situation on the basis of the comparison, and to assess the incidence of complications in different periods and the related factors. Results: male 23, female 32 cases of this group of patients,average age (60.55±7.82) (46-79),preoperative clinical manifestations of the refractory for dense 8 cases of lumbago, lumbar pain associated with radioactive leg pain 54 cases of lower limbweakness in 16 cases, 51 cases with intermittent claudication, lower limbnumbness, 54 cases,cauda equina syndrome 7 cases, preoperative low back pain VAS score 7.06±1.88 points, leg pain VAS score 8.70±0.81 points, function of lumbar JOA score 8. 73±2. 14 points; Average Cobb Angle (30.58°±13.03°)(10°-67°),lumbar lordosis Angle for (26.53°±15.74°)(-10°-60°),pelvic tilt Angle for (56.33°±15.21°)(25°-90°), lumbar instability degree 2.42±089 (0-3), lumbar vertebra unbalance degree 1.41 ±0.14 (0-3), degree of stenosis of 2.13±0.09 (1-3), top vertebral rotation degrees 2.11±0.10 (3-0). The mean follow-up time was 23.3±12.7 months(12.5 to 39 months). Most of the patients with postoperative clinical symptoms and functional score improved significantly, different features in different periods: leg pain, numbness of general ease at early stage, low back pain, lower limb weakness in a slow and continuous and follow-up to the last,there are still 19% of the patients with residual mild lumbocrural pain, a handful of patients there is still a weak lower limb feel barriers or force. Lumbar function of postoperative recovery characteristics can be divided into four period inflammatory edema subsiding stage, rapid recovery, recovery and stability of sustained recovery period, the complication rates were 21.82%, 3.63%, 21.82%, 1.82%; Early postoperative complications and high and low bone mass in older, preoperative lumbago > leg pain, number of fusion ≧3, poor fusion to L5 and S1, LL correct have significant correlation (P < 0.05); The incidence of chronic complications is low; Group was 94.55%, renovated at a rate of 5.45%, low back pain is a major symptom, incidence of renovated infection and degenerative is the main reason, and early postoperative pain relieve renovation rate higher; The optimum rate was 66.67% after renovations.Conclusion:The use of posterior multi-segment spinal canal decompression, interbody fusion, nail orthopedic fixation in the treatment of moderate ADS, can get better early clinical results, Iong-term results are satisfactory, preoperative to strictly grasp Surgical indications,to avoid the relevant risk factors; clear responsibility phase, complete decompression, the appropriate choice of interbody fusion and the fixed stage of postoperative clinical effect is also essential. As the degenerative lumbar scoliosis more common in the elderly, the main purpose of patients with treatment is to all eviate the clinical symptoms, to solve the low back pain and lower extremity radiating pain, improve the quality of life. The appearance of the requirements are not high, so the deformity is not the main factor affecting the quality of life. So the main purpose of surgery is to relieve pain, rebuild or maintain the balance of the trunk to prevent the progress of deformity. Surgical treatment program should follow the principle of individualization, with the smallest trauma to obtain the greatest clinical efficacy, degenerative scoliosis treatment still exists a lot of problems and disputes, the need for multi-center, large sample of research and analysis to get more Good treatment effect.