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題 名 | Spinal Fusion and Pedicle Screw Instrumentation in the Treatment of Spondylolisthesis Over the Age of 60=用椎足螺釘及脊椎融合術來治療60歲以上脊椎滑脫病人之經驗 |
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作 者 | 王柏然; 陳文哲; 陳力輝; 牛自健; | 書刊名 | 長庚醫學 |
卷 期 | 21:4 1998.12[民87.12] |
頁 次 | 頁436-441 |
分類號 | 416.61 |
關鍵詞 | 脊椎滑脫; 脊椎融合術; 椎板切除術; 椎足螺釘固定術; 老年人; Spondylolisthesis; Spine fusion; Laminectomy; Pedicle screw instrumentation; Old age; |
語 文 | 英文(English) |
中文摘要 | 背景:用鋼釘及脊椎融合術來治療老年人的脊椎滑脫仍有爭議。本篇研究的目的就 是要來評估60歲以上的病人以脊椎減壓術脊椎融合術及脊椎內固定術治療的臨床結果。 方法:從1993年到1994年74位60歲以上的病人接受了脊椎減壓術。後外側脊椎融合術及椎足 螺釘固定術(pedicle screws instrumentation)。所有病人術後都接受了術後3個月、6個 月、1年然後每年的門診追蹤。門診追蹤包括臨床症狀記錄及X光的檢查,追蹤時間從2年至4 年。最後我們設計了一份問卷來評估最後的結果。 結果:75位病人背痛改善,75位病人(80%)腳痛改善,65位病人(69%)不需服用止痛藥 ,平均一次的步行距離2.2公里,74位病人(79%)X光顯示融合良好,20位病人(21%)融 合不足,但沒有假關詳形成。併發症不如預期多。 結論:脊椎減壓術、脊椎融合術及脊椎固定術是治療年紀大而脊椎滑脫病人的一個好方法, 它可以得到令人滿意的臨床結果。 |
英文摘要 | Background: Spinal fusion or instrumentation for the treatment of spondylolisthesis in eldery people is still an issue of controversy. The purpose of this study was to assess the clinical results of laminectomy, posterolateral fusion, and pedicle screw instrumentation in patients over age 60. Materials and Methods: From 1993 through 1994, 94 spondylolisthesis patients over age 60 underwent laminectomy, posterolateral fusion and pedicle screw instrumentation. All the patients had follow-up examinations 3 months, 6 months, 1 year and then annually after the operation. At each follow-up visit, the clinical results and complications were evaluated and a radiographic assessment was performed. The follow-up period ranged from 2 to 4 years. At the final follow-up visit, we administered a questionnaire designed for clinical evaluation. Results: Seventy-five patients(80%) obtained improvement in back pain, 75 patients(80%) got improvement in leg pain, and 65 patients(69%) needed no medications. The average distance the patients were able to walk, at one time was 2.2km. Sixty-seven patients(71%) could walk more than 500 m at a time. Seventy-four patients(79%) showed solid fusion, 20 patients inadequate fusion, and no pseudoarthrosis was found. Complications were rate. Conclusion: Laminectomy with spinal fusion and instrumentation is a good method for the treatment of spondylolisthesis in eldery people, and it can achieve a satisfactory clinical outcome. |
本系統中英文摘要資訊取自各篇刊載內容。