本文選題：退變性腰椎滑脫癥　切入點：腰椎融合　出處：《山西醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討并分析退變性腰椎滑脫癥患者在經(jīng)過PLIF(posterior lumbar interbody infusion)術(shù)后其下腰痛與腰椎生理曲度變化的相關(guān)性。方法:回顧性分析我院于2012年11月-2014年1月由骨科收治的43例接受腰椎PLIF(posterior lumbar interbody infusion)術(shù)的退變性腰椎滑脫癥并且術(shù)后出現(xiàn)下腰痛的患者臨床資料,進(jìn)行為期12個月的隨訪,在隨訪的患者中其中8名患者失訪,其余35名患者(男11人,女24人),平均年齡為62.4歲。對患者術(shù)前、術(shù)后6個月、術(shù)后12個月患者的腰椎進(jìn)行站立位正位、側(cè)位X線片,測量其腰椎矢狀位Cobb角,同時通過統(tǒng)計學(xué)方法分析腰椎Cobb角的變化與患者術(shù)后臨床療效的相關(guān)性。結(jié)果:手術(shù)后6個月與手術(shù)后12個月的VAS(visual analogue scale)評分與手術(shù)前相比,有非常明顯的改善(t=3.2108,P=2.099×10-03及t=0.1682,P=3.610×10-04);同時患者術(shù)后6個月與術(shù)后12個月的ODI(Oswestry disability index)評分也有顯著的改變(t=2.2411,P=0.02829及t=2.7615,P=7.395×10-03);術(shù)前腰椎矢狀位Cobb角與術(shù)后6、12個月比較差別無統(tǒng)計學(xué)意義(t=-0.0337,P=0.9732及t=-0.1607,P=0.8728);術(shù)后6個月及術(shù)后12個月所有患者的腰椎前凸改變與VAS(visual analogue scale)評分及ODI(Oswestry disability index)評分均呈正相關(guān)(r=0.6235P=0.0005,r=0.5685 P=0.0004及r=0.6512 P=0.0005,r=0.6055 P=0.0004)。結(jié)論:退變性腰椎滑脫癥患者接受后路腰椎融合術(shù)后其下腰痛與腰椎前凸的改變關(guān)系緊密,因此手術(shù)過程中腰椎前凸的重建對術(shù)后臨床療效有著積極的作用。同時PLIF(posterior lumbar interbody infusion)術(shù)治療退變性腰椎滑脫癥患者其臨床療效顯著。
[Abstract]:Objective: to investigate and analyze the correlation between the changes of lumbar physiological curvature and lower back pain in degenerative lumbar spondylolisthesis patients after PLIF(posterior lumbar interbody infusion.Methods: from November 2012 to January 2014, we retrospectively analyzed the clinical data of patients with degenerative lumbar spondylolisthesis treated in orthopaedic department from November 2012 to January 2014. Clinical data of 43 patients with degenerative lumbar spondylolisthesis undergoing PLIF(posterior lumbar interbody fusion and postoperative low back pain, During a 12-month follow-up, 8 of the patients were not visited, while the remaining 35 patients (11 males and 24 females, with an average age of 62.4 years) were treated preoperatively and 6 months after surgery. After 12 months of operation, the lumbar vertebrae were taken to stand in positive position, and lateral X-ray film was taken to measure the Cobb angle in sagittal position of lumbar vertebrae. At the same time, the correlation between the changes of Cobb angle of lumbar vertebrae and the clinical curative effect was analyzed by statistical method. Results: the VAS(visual analogue scale score of 6 months after operation and 12 months after operation was compared with that before operation. There were very significant improvements in the ODI(Oswestry disability scores of t 2.2108g / g 2.099 脳 10 ~ (-3) and t 0.1682n / min ~ (3.610 脳 10 ~ (-04)) respectively. There were also significant changes in the scores of ODI(Oswestry disability at 6 months after operation and 12 months after operation. The scores of t _ (2.2411) P _ (0.02829) and t _ (2.7615) P _ (7.395) 脳 10 ~ (-03) were also significantly improved. There was no significant difference between preoperative and postoperative Cobb angles in sagittal position of lumbar vertebrae and 6, 12 months after operation. There was no significant difference between preoperative Cobb angle and postoperative Cobb angle (t = 0.0337P ~ (0.9732) and t ~ (-0.1607) P ~ (0.8728)). Lumbar kyphosis was positively correlated with VAS(visual analogue scale score and ODI(Oswestry disability index score in all patients 6 and 12 months after operation. Conclusion: patients with degenerative lumbar spondylolisthesis underwent posterior lumbar fusion after posterior lumbar fusion with 0.5685P0.0004 and 0.6512P0.0005P0.6055P0.0004.Conclusion: the patients with degenerative lumbar spondylolisthesis underwent posterior lumbar fusion. Lumbar pain is closely related to the change of Lumbar Lumbar kyphosis. Therefore, the reconstruction of lumbar lordosis during the operation has a positive effect on the postoperative clinical efficacy. Meanwhile, PLIF(posterior lumbar interbody fusion has a significant clinical effect in the treatment of degenerative lumbar spondylolisthesis.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

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