强直性脊柱后凸截骨矫正内固定术  

Internal fixation and osteotomy correction of spondylitis ankylopoietica kyphosis

作　　者：田慧中[1] 王彪[1] 吕霞[1] 刘奋[1] 

机构地区：[1]广东省佛山市南海区西樵人民医院脊柱外科,528211

出　　处：《中国矫形外科杂志》2005年第7期509-512,共4页Orthopedic Journal of China

摘　　要：目的:介绍强直性脊柱后凸病人的截骨矫正方法和选择性内固定的手术方法.方法:对重度强直性脊柱后凸,应采取的截骨方法有棘突至椎体后缘的V形截骨术、次全椎弓椎体截骨术、全脊柱截骨术三种不同的截骨方法.选择性内固定的手术方法,有双侧Luque棍夹持棘突钢丝固定法、弓根螺钉加压棍固定法、棘突间钢丝固定法,如果选择病例合适,应用方法得当,其固定效果均满意.结果:在560例患者中,能随访到的重度强直性脊柱后凸100例.随访时间为2～10年,截骨部位均在6～12个月时,出现椎体间和椎板后的骨性融合.术后人体外形明显改善,心肺功能、二氧化碳和氧气交换好转,病人的精神面貌焕然一新,食欲好转,营养状况改善,使病人的体质恢复正常.结论:治疗重度强直性脊柱后凸(Cobb'角80°以上者),所采用的截骨方法与轻度强直性脊柱后凸(Cobb'角80°以内者)是完全不同的.重度强直性脊柱后凸截骨矫正术后,内固定是不可缺少的,而且内固定的方法还要恰当选择.Objective:To introduce the corrective method through the osteotomy and selective internal fixation for treatment of severe ankylosing spondylitis kyphosis.Method:There are three different methods of osteotomy in severe ankylosing spondylitis kyphosis,V shape osteotomy which was simple lamina osteotomy from spinous to bodies post-edge,subtotal spinal osteotomy and total spinal osteotomy,The operative method of selective internal fixation has three different ways.They are bilateral Luque rods and wire,pedicle screw with compressive rod,interspinal wire.If selected the property case and right procedure that the fixative effect will be satisfactory.Result:There were 100 cases followed-up in 560 cases,the followed up term was 2 to 10 years.The position of osteotomy appeared the synostoses of inter bodies and posterior lamina in 6 to 12 months.After operation,the patient's appearance were obviously improved,the cardio-pulmonary function and carbon-oxygen exchange were all on the mend.The patient's spiritural outlook took on an entirely new look.Raised appetite made the nutrition got a good mend,the patient's heath returned to normal step by step.Conclusion:Adopting method of osteotomy was totally different in the treatment of severe ankylosing spondylitis kyphosis and light ankylosis spondylitis kyphosis.Internal fixation was indispensable in the post osteotomy of severe ankylosing spondylitis kyphosis and fixative method must be properly selected.

关 键 词：强直性脊柱炎 脊柱后凸 截骨术 内固定术 

分 类 号：R687[医药卫生—骨科学]