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[目的]探讨后路选择性双侧交替置钉钉棒矫形内固定治疗青少年脊柱侧凸的临床疗效。[方法]选择本院2012年1月~2014年12月收治的60例青少年脊柱侧凸患者,临床均给予后路选择性双侧交替置钉钉棒矫形内固定术治疗。术后随访1~2年,观察患者术前、术后脊柱Cobb角变化(矢状面胸椎后凸Cobb角、胸腰段前凸Cobb角和腰椎前凸Cobb角)和脊柱变化(顶椎旋转度、躯干位移和身高)、健康评分(SF-36)变化、脊柱情况(SRS-22)。[结果]术后半年、1年时患者矢状面胸椎后凸Cobb角、胸腰段前凸Cobb角、腰椎前凸Cobb角较术前均显著改善(P<0.05)。术后半年、1年时患者脊柱顶椎旋转度、躯干偏移度、身高变化较术前均显著改善(P<0.05)。末次随访时SF-36各指标(生理功能、生理职能、躯体疼痛、总体健康、情感职能、生命活力、社会功能)较术前均显著改善(P<0.05)。末次随访时患者SRS-22各指标(自我形象、功能活动、精神健康、疼痛程度)较术前均显著改善(P<0.05)。[结论]后路选择性双侧交替置钉钉棒矫形内固定治疗青少年脊柱侧凸,能显著改善脊柱畸形,恢复脊柱正常的生理弯曲,提高生活质量。
[Objective] To explore the clinical effect of posterior selective bilateral replacement nail rod orthopedic fixation for adolescent scoliosis. [Methods] Sixty patients with juvenile scoliosis who were treated in our hospital from January 2012 to December 2014 were enrolled in this study. All patients were treated with posterior selective bilateral cross-stapling orthopedic fixation. The changes of Cobb angle (Cobb angle in sagittal plane, Cobb angle in thoracolumbar lumbar and Cobb angle in lumbar lordosis) and spine changes Degree, torso shift and height), changes in health score (SF-36), spine status (SRS-22). [Results] Cobb angle, thoracolumber lumbar Cobb angle and lumbar lordosis Cobb angle of sagittal plane were significantly improved at 6 months and 1 year after operation (P <0.05). At 6 months and 1 year after operation, the apex rotation, torsion deviation and height of the spine were significantly improved (P <0.05). At the final follow-up, the indexes of SF-36 (physiological function, physiological function, somatic pain, general health, emotional function, vitality and social function) were significantly improved compared with that before operation (P <0.05). At the final follow-up, the SRS-22 indicators (self-image, functional activity, mental health and pain level) were significantly improved compared with those before operation (P <0.05). [Conclusion] Posterior selective bilateral fixation of pedicle screw rod and orthopedic fixation for adolescent scoliosis can significantly improve spinal deformity, restore the normal physiological curvature of the spine and improve the quality of life.