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目的 探讨机器人辅助内固定选择性融合减压术治疗退行性脊柱侧凸（ADS）的临床效果。方法 选取行机器人辅助内固定融合减压术的ADS患者78例，其中选择性融合减压术41例（一组）、全弯融合减压术37例（二组）；比较两组融合椎体数、术中出血量及手术时间，术前及术后6个月分别用Cobb角、下腰痛功能障碍调查表（RMDQ）、视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）、日本骨科协会评分（JOA）评价疗效，观察两组术后并发症发生情况。结果 与二组比较，一组融合椎体数少、术中出血量少、手术时间短（P均<0.05）。与术前比较，两组术后Cobb角均减小（P均<0.05）；与二组比较，一组术后Cobb角大、Cobb改善角小（P均<0.05）。与术前比较，术后6个月时两组VAS均升高，RMDQ、ODI及JOA均降低（P均<0.05）。与二组比较，一组JOA降低（P<0.05）。两组术后并发症发生情况比较差异均无统计学意义（P均>0.05）。结论 机器人辅助内固定选择性融合减压术治疗ADS效果较好，可有效改善临床症状。
Abstract：Objective To evaluate the clinical effect of selective decompression and fusion with robot-assisted internal fixation in the treatment of adult degenerative scoliosis(ADS). Methods Seventy-eight patients with ADS undergoing fusion and decompression with robot-assisted internal fixation were retrospectively analyzed. These patients were divided into two cohorts: Group 1(n=41) receiving selective fusion and decompression, and Group 2(n=37) undergoing fullcurve fusion and decompression. Intraoperative parameters(the number of fused vertebrae, operative time, and blood loss) and clinical outcomes were compared. The therapeutic effects before and 6 months after operation was assessed by Cobb angle measurement, Roland-Morris Disability Questionnaire(RMDQ), Visual Analog Scale(VAS), Oswestry Disability Index(ODI), and Japanese Orthopaedic Association(JOA) score. Postoperative complications were documented.Results Compared with Group 2, Group 1 demonstrated significantly fewer fused vertebrae, reduced operative time, and lower intraoperative blood loss(all P<0. 05). Both groups exhibited postoperative Cobb angle reduction in comparison with the preoperative values(both P<0. 05); however, Group 1 showed a larger residual Cobb angle and smaller angular correction than Group 2(both P<0. 05). At 6-month follow-up, both groups showed significant improvements in VAS, RMDQ, ODI, and JOA scores compared to the baseline(all P<0. 05). Group 1 had lower JOA scores than Group 2(all P<0. 05).No significant differences were found in the complications between these two groups(all P>0. 05). Conclusion Selective fusion and decompression with robot-assisted internal fixation is more effective in the treatment of ADS, and it can effectively improve clinical symptoms.
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基本信息:
DOI：
中图分类号:R687.3
引用信息:
[1]袁宁,赵经纬,何达等.机器人辅助内固定选择性融合减压术治疗退行性脊柱侧凸的临床疗效[J].山东医药,2025,65(05):1-6.
基金信息:
北京市自然科学基金面上项目（7232336）