后路经椎弓根侧方旋转复位技术治疗退行性腰椎侧凸的临床应用

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Abstract Objective To investigate the clinical efficacy of posterior transpedicular lateral rotatory reduction in treatment of degenerative lumbar scoliosis(DLS).Methods 21 patients of DLS received posterior transpedicular lateral rotatory reduction，interbody fusion and internal fixation of pedicle system treatment from January 2013 to January 2016.All patients were followed up for 8 to 28 months with an average of (18.0±1.5)months.We retrospectively analyzedthe clinical materials，changes of oswestry disability index(ODI)，Japanese orthopaedic association scores(JOA)，apical vertebral rotation，lumbar lordotic angle and scoliosis Cobb angle pre-operationand post-operation were evaluated comprehensively.Results All patients underwent the operation successfully.One patient suffered from L₄ neural root lesion after the operation but relieved after treatment and rehabilitation.Low back pain，lower limb pain，and neurogenic claudication improved significantly.Preoperative ODI was(39.1±8.0)on average and(15.2±2.2)for the last follow-up，which were obviously reduced compared to that before the surgery(P＜0.05).Preoperative JOA was(11.5±2.3)on average and(25.4±1.3)for the last follow-up，which were significantly increased compared to that before the surgery(P＜0.05).Apical vertebral rotation was corrected to (6.4±1.7)° from preoperative(17.5±2.2)°.Lumbar lordotic angle increased from (10.6±2.7)°to(26.3±1.5)°and scoliosis Cobb angle was reduced from (28.6±2.5)°to(8.7±1.3)°.Internal fixation loosening，rotation and breakage were not seen during follow-up.Conclusion After adoption of posterior transpedicular lateral rotatory reduction in combination with posterior decompression，interbody bone grafting and pedicle screw internal fixation in treating DLScan effectively correct lumbar scoliosis and recover lumbar lordosis，with satisfactory clinical efficacy.

Key words： degenerative lumbar scoliosis coronal plane orthopedic pedicle screw internal fixation interbody fusion

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