{"title":"多节段皮质骨轨迹螺钉治疗老年人退行性脊柱侧凸伴狭窄的安全性和有效性：至少5年随访研究。","authors":"Jie Wang, Zihao Ding, Yuzeng Liu, Yong Hai","doi":"10.2147/CIA.S527306","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the long-term efficacy and safety of multi-segment cortical bone trajectory screws for treating mild adult degenerative scoliosis with stenosis among the elderly.</p><p><strong>Patients and methods: </strong>From January 2018 to December 2019, a total of 41 patients of mild adult degenerative scoliosis with stenosis underwent posterior lumbar decompression, bone graft fusion, and internal fixation, which were retrospectively divided into pedicle screw (PS) group and cortical bone trajectory (CBT) screw group according to different internal fixation methods. The operation time, intraoperative blood loss, immobilization, and length of hospital stay were compared between the two groups. The visual analog score (VAS) of low back and leg pain, Oswestry disability index (ODI), Cobb angle, lumbar lordosis (LL) angle, apex vertebral translation (AVT), coronal balance distance (CBD) and sagittal vertical axis (SVA) were compared between the two groups preoperatively and 6 months, 1 year, 5 years postoperatively. Perioperative and follow-up complications were observed.</p><p><strong>Results: </strong>The CBT group was superior to PS group in operation time, intraoperative blood loss, immobilization, length of hospital stay (<i>P</i><0.05). The low back VAS and ODI in CBT group were significantly lower than those in PS group at 6 months, 1 year and 5 years postoperatively (<i>P</i><0.05). The leg VAS in CBT group was lower than PS group at 5 years postoperatively (<i>P</i><0.05). The incidence of screw loosening and adjacent segment disease 5 years postoperatively in CBT group was significantly lower than that in PS group (<i>P</i><0.05).</p><p><strong>Conclusion: </strong>Multi-segment cortical bone trajectory screws is a safe and effective treatment option for mild adult degenerative scoliosis with stenosis among the elderly. This technique features miniinvasive trauma and quick recovery, which might lead to improved long-term quality of life and a reduction in screw loosening and adjacent segment disease rates.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1125-1135"},"PeriodicalIF":3.7000,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315861/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Safety and Effectiveness of Multi-Segment Cortical Bone Trajectory Screws in Adult Degenerative Scoliosis with Stenosis Among the Elderly: Minimum 5-year Follow-up Study.\",\"authors\":\"Jie Wang, Zihao Ding, Yuzeng Liu, Yong Hai\",\"doi\":\"10.2147/CIA.S527306\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To evaluate the long-term efficacy and safety of multi-segment cortical bone trajectory screws for treating mild adult degenerative scoliosis with stenosis among the elderly.</p><p><strong>Patients and methods: </strong>From January 2018 to December 2019, a total of 41 patients of mild adult degenerative scoliosis with stenosis underwent posterior lumbar decompression, bone graft fusion, and internal fixation, which were retrospectively divided into pedicle screw (PS) group and cortical bone trajectory (CBT) screw group according to different internal fixation methods. The operation time, intraoperative blood loss, immobilization, and length of hospital stay were compared between the two groups. The visual analog score (VAS) of low back and leg pain, Oswestry disability index (ODI), Cobb angle, lumbar lordosis (LL) angle, apex vertebral translation (AVT), coronal balance distance (CBD) and sagittal vertical axis (SVA) were compared between the two groups preoperatively and 6 months, 1 year, 5 years postoperatively. Perioperative and follow-up complications were observed.</p><p><strong>Results: </strong>The CBT group was superior to PS group in operation time, intraoperative blood loss, immobilization, length of hospital stay (<i>P</i><0.05). The low back VAS and ODI in CBT group were significantly lower than those in PS group at 6 months, 1 year and 5 years postoperatively (<i>P</i><0.05). The leg VAS in CBT group was lower than PS group at 5 years postoperatively (<i>P</i><0.05). The incidence of screw loosening and adjacent segment disease 5 years postoperatively in CBT group was significantly lower than that in PS group (<i>P</i><0.05).</p><p><strong>Conclusion: </strong>Multi-segment cortical bone trajectory screws is a safe and effective treatment option for mild adult degenerative scoliosis with stenosis among the elderly. This technique features miniinvasive trauma and quick recovery, which might lead to improved long-term quality of life and a reduction in screw loosening and adjacent segment disease rates.</p>\",\"PeriodicalId\":48841,\"journal\":{\"name\":\"Clinical Interventions in Aging\",\"volume\":\"20 \",\"pages\":\"1125-1135\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-07-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315861/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Interventions in Aging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/CIA.S527306\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Interventions in Aging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/CIA.S527306","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
The Safety and Effectiveness of Multi-Segment Cortical Bone Trajectory Screws in Adult Degenerative Scoliosis with Stenosis Among the Elderly: Minimum 5-year Follow-up Study.
Purpose: To evaluate the long-term efficacy and safety of multi-segment cortical bone trajectory screws for treating mild adult degenerative scoliosis with stenosis among the elderly.
Patients and methods: From January 2018 to December 2019, a total of 41 patients of mild adult degenerative scoliosis with stenosis underwent posterior lumbar decompression, bone graft fusion, and internal fixation, which were retrospectively divided into pedicle screw (PS) group and cortical bone trajectory (CBT) screw group according to different internal fixation methods. The operation time, intraoperative blood loss, immobilization, and length of hospital stay were compared between the two groups. The visual analog score (VAS) of low back and leg pain, Oswestry disability index (ODI), Cobb angle, lumbar lordosis (LL) angle, apex vertebral translation (AVT), coronal balance distance (CBD) and sagittal vertical axis (SVA) were compared between the two groups preoperatively and 6 months, 1 year, 5 years postoperatively. Perioperative and follow-up complications were observed.
Results: The CBT group was superior to PS group in operation time, intraoperative blood loss, immobilization, length of hospital stay (P<0.05). The low back VAS and ODI in CBT group were significantly lower than those in PS group at 6 months, 1 year and 5 years postoperatively (P<0.05). The leg VAS in CBT group was lower than PS group at 5 years postoperatively (P<0.05). The incidence of screw loosening and adjacent segment disease 5 years postoperatively in CBT group was significantly lower than that in PS group (P<0.05).
Conclusion: Multi-segment cortical bone trajectory screws is a safe and effective treatment option for mild adult degenerative scoliosis with stenosis among the elderly. This technique features miniinvasive trauma and quick recovery, which might lead to improved long-term quality of life and a reduction in screw loosening and adjacent segment disease rates.
期刊介绍：
Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.
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