形状记忆合金脊柱侧凸矫正系统的设计与临床应用  

Design and clinical study of shape memory alloy scoliosis correction system

作　　者：王岩[1] 卢世璧[1] 张永刚[1] 刘保卫[1] 刘郑生[1] 肖嵩华[1] 张雪松[1] 

机构地区：[1]解放军总医院骨科,北京100853

出　　处：《中国矫形外科杂志》2005年第17期1289-1291,共3页Orthopedic Journal of China

摘　　要：[目的]探讨形状记忆合金脊柱侧凸矫正系统的设计及其临床应用,评价其疗效.[方法]1980年以来本院骨科相继进行了记忆合金棒结合椎板下钢丝矫正系统和记忆合金棒结合椎弓根螺钉矫正系统的设计和临床应用,共计治疗73例特发性脊柱侧凸患者,其中,前者后路一期手术矫形共计68例,后者后路一期矫治特发性脊柱侧凸患者5例.[结果]采用一代系统的68例患者中,完成5 a以上完整随访的58人,Cobb角由术前平均54.2°矫正至25.8°,术后5 a随访时平均28.3°.采用二代系统的5例患者经过1～4 a的随访,Cobb角由术前平均57.8°矫正至17.8°,术后1 a以上随访未见矫正丢失.[结论]利用形状记忆和超弹性的属性,形状记忆合金脊柱侧凸矫正系统能够取得较为理想的矫正效果,结合椎弓根钉可以取得更好的三维矫形效果.[ Objective] To investigate design and clinical study of shape memory alloy scoliosis correction system, and to evaluate the correction effect. [ Method] The first generation of shape memory alloy scoliosis correction system （SMAS） constituted of shape memory alloy rod and sublamina steel-wire was designed and clinically applied from 1980s in 68 cases; and the second generation of SMAS constituted of shape memory alloy rod and pedicle screws was applied in 5 cases from 1990. Patients were evaluated before surgery, immediately after surgery, and at least an 1 year follow-up according to radiographic changes in curve correction and its maintaining situation was carried out. [ Result] In the first generation group, 58 cases of 68 patients finished 5 years＇ follow-up, preoperative structural curve Cobb angle of 54.2° were corrected to averaged 25.8°, the correction. rate was 52%, and in the end of the 5 year＇ follow-up the correction angle was averaged 28.3° . In the second generation group, all cases finished 1 -4 years＇ follow-up, preoperative structural curve Cobbs angle of 57.8° were corrected to average 17. 8°, the correction rate was 69. 8%, and no obvious correction lost were found. There was no serious complication peri-operative!y in both group, no instrument broken was found. [ Conclusion] Based on shape memory and hyperelastic nature, SMAS can achieve ideal correction safely and effectively, no biocompatibility problem was found. The second generation SMAS have better 3 dimensional correction and maintenance ability.

关 键 词：镍钛记忆合金 脊柱侧凸 椎弓根螺钉 特发性脊柱侧凸 形状记忆合金 其临床应用 矫正系统 设计 COBB角 椎板下钢丝 

分 类 号：R687.3[医药卫生—骨科学]