半椎体切除术治疗先天性脊柱侧凸30例  

Hemivertebra resection for treatment of congenital scoliosis(report of 30 cases)

作　　者：王继孟[1] 张敏刚[1] 王恒冰[1] 王廷宙[1] 王兴山[1] 

机构地区：[1]山东省立医院小儿骨科,济南250021

出　　处：《临床小儿外科杂志》2008年第2期22-24,共3页Journal of Clinical Pediatric Surgery

摘　　要：目的评价一期半椎体切除、前后路松解手术治疗先天性半椎体的疗效,并探讨术中相关问题。方法本组30例,平均年龄8岁(1岁6个月至17岁),其中年龄小于4岁6例。30例均行一期前后路松解、半椎体切除术,选择合适的器械进行前路或后路固定,并行局部植骨融合。结果术后1周X线复查,平均Cobb角为16°(0°～32°),术前Cobb角为33°～69°,平均矫正率为68.7%。21例获随访1年以上,最终平均Cobb角为15°(0°～30°),30例最终矫正率为71.6%,术后植骨融合部位骨痂形成良好,无感染、内固定器械断裂等并发症。结论早期一期前后路松解、半椎体切除是治疗小儿先天性脊柱侧凸的有效方法,应根据适应证严格选择病例和合适的固定器械,并作好详细的术前检查。Objective To evaluate the effect of the procedure of relaxation of vertebrae through anterior and posterior approach and resection the hemivertebra in one stage for congenital scoliosis and to discuss some problem related with the procedure. Methods In this group there were 30 cases who were identified congenital hemivertebra,aged from 1.5 to 17 years old （average 8 years old）. Six patients were less than 4 years old. At one stage all 30 cases underwent the procedure of resection of hemivertebra and relaxation through anterior and posterior approach. The contiguous vertebra were fixed through anterior or posterior internal instrument and fused by embebding bone. Results The X ray film was reexamined in one week after operation.The cobb angle was 0-32 （average 16）,while the cobb angle was 33-69 （average 51） preoperatively.The rate of correction was 68.7%.21 cases were followed-up more than one year,whose cobb angle was 0-30 （average 15）.There were no complications,neither neural dysfunction,infection nor fracture of internal instrument,be found. Conclusions The procedure of relaxation of vertebrae through anterior and posterior approach and resection the hemivertebra at one stage is satisfying in treatment for congenital scoliosis in children.And the procedure should be undergone early.

关 键 词：先天性脊柱侧凸 半椎体切除术 外科学 治疗方法 

分 类 号：R687.3[医药卫生—骨科学]