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退变性腰椎侧凸长节段矫形固定术后腰椎功能评估的研究进展

Advance in evaluation of lumbar function after long fixation of degenerative scoliosis

摘要:

随着人口老龄化的加剧,退变性腰椎侧凸(DLS)的患病率逐年提高,而长节段矫形固定融合术是治疗严重DLS的重要方法.目前,术后效果的评估主要根据术后临床症状的缓解程度及影像学上畸形矫正和平衡状态改善情况.虽然手术具有较高的难度和风险,但多数患者可在手术中受益.然而,长节段固定融合在缓解疼痛症状、改善生活质量的同时,会造成腰椎局部活动度的下降,导致腰部僵硬,从而在一定程度上影响日常生活活动能力(ADL).腰椎僵硬功能障碍指数(LSDI)作为评估腰椎僵硬对ADL影响的量表,已得到广泛应用.但该量表也具有一定的局限性,需要在优化的基础上应用.本文对DLS长节段矫形固定术后腰椎功能评估的研究进展及LSDI的临床应用现状进行综述.

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abstracts:

With the aging of the population,the incidence of degenerative lumbar scoliosis has increased year by year.Long-segment orthopedic fixation surgery is an important method for the treatment of severe degenerative lumbar scoliosis.Currently,the evaluation of postoperative results is mainly based on the degree of relief of postoperative clinical symptoms,as well as the improvement of imaging deformity and balance.The studies show that although surgery has high difficulty and risk,most patients can benefit from surgery.Besides,it is reported that long-segment fixation can alleviate the symptoms of pain and improve the quality of life.However,it also decreases the local activity of the lumbar spine,leading to stiffness of lumbar,which may affect the activities of daily living (ADL) partly.Lumbar Stiffness Disability Index (LSDI) is a scale for evaluating the impact of lumbar spine stiffness on ADL.The scale has certain limitations and needs to be applied to Chinese people on the basis of optimization.In this paper,the researches of lumbar spine function evaluation after degenerative lumbar scoliosis and long segmental orthopedic fixation and the clinical use of LSDI are briefly reviewed.

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作者: 张心灵 [1] 袁磊 [1] 曾岩 [1] 买硕 [1]
第一作者: 张心灵
期刊: 《中华外科杂志》2019年57卷5期 397-400页 MEDLINEISTICPKUCSCD
栏目名称: 综述
DOI: 10.3760/cma.j.issn.0529-5815.2019.05.016
发布时间: 2019-06-06
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