The Comparative Study Of Long-segment And Short-segmental Instrumental Fusion For Degrnerative Lumbar Scoliosis

Objective: to analyze the evaluation of lumbar posterior decompression and fixation and fusion in treatment of degenerative lumbar scoliosis(degenerative lumbar CT images and DLS) clinical curative effect, and relatively long segments and short segment fixation and fusion the two selection conditions and effect of difference.Methods: a retrospective analysis of Shaanxi Provincial People s Hospital; 2012 during the January to July 2014 from 32 cases of severe degenerative lumbar scoliosis patients underwent posterior lumbar decompression and fusion. The basis for patients in fixed day number is divided into two groups: which underwent posterior decompression and short segment fixation and fusion group(a group) 18 cases; posterior decompression long segment fixation and fusion group(group B) in 14 cases. Measure and record all patients(A group and B group) before operation and last follow-up Cobb angle of scoliosis and lumbar lordosis(LL), and according to the measured values were calculated to improve the rate of analysis; recording and analysis of the average operation time, A group and B group of patients with bleeding, surgery BOC decompression segments and the fixed segment number of indicators; two groups(group A and group B) score of low back pain JOA score, pain before and after surgery(VAS), Oswestry disability index(ODI) as the evaluation indexes, calculate its value recorded excellent rate statistics and analysis the value parameter evaluation index(analysis, using SPSS19.0 statistical software test set the standard for a=0.05), according to the above all measurement parameters and numerical evaluation index, analysis and evaluation of the difference and effect of selection conditions of these two groups of different fixation fusion for degenerative lumbar scoliosis, and to select the two groups of different treatment of degenerative spinal column provides a theoretical basis for scoliosis.Results: group A preoperative Cobb Angle(16.3 ± 3.1 °), the last follow-up(9.4 ± 2.6 °), period of 45.9%;Group B(26.9 ± 4.8 °) for preoperative Cobb Angle, the last follow-up(9.2±4.1 °), the period 65.2%, Cobb Angle between the two groups compare the indicators and separately in two groups of preoperatie and follow-up sessions at the end of the comparative differences are statistically significant(P < 0.05), group B Cobb Angle is A significant improvement in group A;Lumbar lordosis Angle preoperative group A(22.4 ± 6.4 °), the last follow-up(31.9 ±8.3 °), period of 26.9%;Group B physiological preoperative lordosis Angle(19.1 ±6.8 °), the last follow-up(30.2 ±7.5 °), the period 29.5%, physiological lordosis Angle period compare differences between the two groups had no statistical significance(P > 0.05);In the two groups were compared to the last follow-up preoperative lordosis Angle were statistically significant(P < 0.05), two groups in terms of improving lumbar lordosis Angle has the similar clinical effect and effect. Results in group A, the average fixed segment number( 2.6 ±0.8), average decompression segment results for(2.2 ± 0.5); group B average fixed segment number results(5.6 ±1.4), average decompression segment results(3.1 ± 1.2); average fixation, decompression section number in group B than group A, between the two groups segmental decompression and fixation and had statistical significance(P < 0.05); the operation time and bleeding volume of patients in group B is greater than that of the patients in group A(P < 0.05). There was no difference in the improvement rate of J0 A score(P > 0.05). There was no difference in the excellent and fine rate of ODI(P > 0.05). There was no difference in the excellent and good rate of VAS(P > 0.05).Conclusion:1. Long segment and short segment fixation and fusion surgery for degenerative lumbar scoliosis can achieve the effective therapeutic effect. It can relieve the symptoms of pain and nerve compression, and it is very effective for improving the quality of life of patients..2. Long segment and short segment fixation of the two surgery compared, long segment fixed in the correction of scoliosis patients(i.e. improvement lumbar Cobb angle) is better than that of short segment fixation, improve the correction effect. Short segment fixation in reduce bleeding area and operation trauma, shorten operation time, better than the long segment fixation.3. Long and short segment fixed the two surgical methods in restoring lumbar lordosis angle, relieve the clinical symptoms had no significant difference.4. Long segment and short segment fixation surgery way choice to comprehensive assessment of the specific circumstances of patients: for the Cobb angle small, spinal anterior or lateral displacement was not suitable for short segment fixation; for the Cobb angle is larger, spinal anterior or lateral shift more serious person choose long segment fixation.