一期后路经椎弓根半椎体切除节段固定治疗先天性胸腰椎侧后凸畸形  

One-stage posterior transpedicle hemivertebra resection and segmental instrumentation in the treatment of congenital kyphoscoliosis caused by thoraco-lumbar hemivertebral

作　　者：王晓东 郝定均 吴起宁 贺宝荣 刘团江 陈海波 方向义 

机构地区：[1]市红十字会医院脊柱外科,西安710054

出　　处：《脊柱外科杂志》2008年第2期80-82,共3页Journal of Spinal Surgery

基　　金：陕西省科技厅社会发展资助项目(2003K10-G26)

摘　　要：目的评价一期后路经椎弓根半椎体切除节段固定术治疗完全分节的胸腰椎半椎体畸形所致的先天性脊柱侧后凸畸形的疗效。方法采用一期后路经椎弓根半椎体切除内固定矫形术治疗了12例完全分节的胸腰椎半椎体畸形所致的脊柱侧后凸畸形。其中男8例,女4例,年龄为7～17岁,平均11.3岁。观察并测量术前术后及随访时站立位脊柱X线片冠状面和矢状面Cobb角、侧凸的顶椎偏移。结果随访10～34个月,平均16个月。术后冠状面平均矫正64.1%,随访中无明显丢失。后凸由术前平均32°矫正至平均19°,随访中无明显丢失,顶椎偏移由术前平均4.5cm矫正至平均1.2cm。无脊髓损伤及切口感染等并发症。结论一期后路经椎弓根半椎体切除内固定矫形术是治疗完全分节的胸腰椎半椎体畸形所致的脊柱侧后凸畸形的有效方法。Objective To evaluate the effectiveness of one-stage posterior transpedicle hemivertebra resection and segmental instrumention in the treatment of congenital kyphoscoliosis caused by thoraco-umbar hemivertebral. Methods Twelve cases of congenital kyphoscoliosis in children underwent one-stage operation of posterior hemivertebra resection and segmental instrumention utilizing pedicle screw system, the average age at surgery was 11.3 years and ranging from 7 to 17 years. The preand post-operation and final follow-up standing radiographic changes were measured. The average cobb angle of scoliosis was 46°preoporatively （range 34° -58°） kyphosis with the cobb angle was 17° （range 5° -26°） . The average trunk shift was 4. 5 cm （ranging from 1.2 cm to 6.8 cm）. Results The average follow-up was 16 months and ranged from 10 to 34 months. Preoperative scoliosis averaging 46°was corrected 17° （ correction rate 64.1% ）, and preoperative kyphosis of 32°was correct to 19% Trunk shift of 4.5 cm improved to 1.2 cm and no loss of correction at final follow-up. There were no infection in all patients, no injure of spinal cord and other severe complications. Conclusion One-tage posterior transpedicle hemivertebra resection and segmental instrumention utilizing pedicle screw system in the treatment of congenital kyphoscoliosis caused by thoraco-lumbar hemivertebral can achieve satisfactory and reliable effect.

关 键 词：胸椎 腰椎 脊柱侧凸 脊柱后凸 截骨术 内固定器 

分 类 号：R682.3[医药卫生—骨科学]