以多環節椎弓螺絲內固定系統從後位做矯正及固定術治療退化性脊椎側彎

退化性脊椎側彎症可定義為：在人生晚年由於骨質疏鬆和脊椎退化性變化在胸腰椎所發展出的側彎症，椎弓螺絲內固定系統（pedicle screw fixation construct）在固定和矯正脊椎方面比鉤子（hook）或鋼絲（wire）更堅硬（rigid），因此，多環節椎弓螺絲內固定系統在治療退化性脊椎側彎，無論在冠狀面和矢狀面，皆能表現出較好的矯正結果。本研究回顧了11個病患在本院接受後外脊椎融合術並以Texas Scottish Rite Hospital（TSRH）多環節椎弓螺絲內固定系統從後位做矯正手術，合併有脊椎狹窄或神經根壓迫之病患均接受減壓術。男女比例是1比1.5，年齡從48至79歲平均年齡64歲，手術前側彎角度從12°至35°，平均25°，追蹤24個月，結果顯示平均側彎角度矯正達60%，疼痛減緩達80%以上，手術後病人在站立時間和行走距離均有明顯改善，無手術後死亡或神經損傷發生，僅有少數輕微併發症。腰椎前彎（lumbar lordosis）的角度和下背痛的發生率有明顯的關聯性，多環節椎弓螺絲內固定系統能矯正出較正常的腰椎前彎。

關鍵字

退化性脊椎側彎症；後位多環節螺絲內固定系統；背痛

並列摘要

Degenerative scoliosis can be defined as scoliosis in the thoracolumbar spine developing later in life as a result of deqenerative change and osteoprosis. Pedicle screw fixation construct have been shown to be more rigid than hook or wire systms. Segmental pedicle screw instrumentution in degenerative scoliosis allow better curve correction and restoration of lumbar lordosis. In a retrospective sutdy, 11 patients of degenerative scoliosis treated with posterolateral fusion and correction with TSRH instrumentation were reviewed. Cases with evidence of spinal stenosis or nerve root involvement were treated with decompression. The male to female ratio is 1 to 1.5. Mean age at surgery was 64 (48-79) years, the preoperative scoliotic curves ranged from 12° TO 35 ° (average 25°). At follw up (mean of 24 months), the average curve correction in the coronal plane was 60%. Overall satisfactory clinical result with pain reduction was more than 80%. Improved standing and walking were seen in patients after operation. Using this techigue no postoperative deaths or neurologic deficits occured. Only a few minor complications were observed. Lumbar lordosis is more easily restored with segmetal pedicle screw instrumentation which is correspond to incidence of low back pain3.

並列關鍵字

degenerative scoliosis ； posterior segmental screw instrumentation ； back pain

國際替代計量

以多環節椎弓螺絲內固定系統從後位做矯正及固定術治療退化性脊椎側彎

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