后路半椎体切除器械矫正内固定治疗先天性脊柱侧凸  

Posterior hemivertebra resection and instrumentation correction in the treatment of congenital scoliosis

作　　者：詹世强[1] 王义生[1] 马元琛[1] 柯雨洪[1] 林秉涛[1] 

机构地区：[1]广东省人民医院骨科

出　　处：《中国矫形外科杂志》2009年第3期168-171,共4页Orthopedic Journal of China

基　　金：广东省科技计划资助项目(编号:2007B031506006)

摘　　要：[目的]探讨后路半椎体切除、器械矫正内固定治疗先天性脊柱侧凸的临床疗效。[方法]2002年7月～2006年12月,后路半椎体切除、器械矫正内固定治疗先天性脊柱侧凸39例,男22例,女17例;平均年龄8.3岁(3～15岁)。完全分节性半椎体30例,部分分节性半椎体9例。内固定器械包括ISOLA16例、CD-Horizon10例、MOSS-Miami10例、TSRH3例。术前后摄站立位全脊柱正侧位片,观察手术前后侧凸的矫正率及躯干平衡情况。[结果]术后随访1～4.5年,平均2.8年,术前冠状面Cobb’s角平均48°,术后13°,末次随访平均13.2°,平均矫正率70.2%。矢状面Cobb’s角术前平均39°,术后12.1°,末次随访12.7°,平均矫正率68.7%。所有患儿植骨融合牢固,躯干平衡良好。无神经系统并发症,无植入物折断及松动、无感染等并发症,1例出现曲轴现象。[结论]后路半椎体切除、器械矫正内固定对先天性脊柱侧凸是一种安全、有效的矫治方法。先天性脊柱侧凸应提倡早期手术矫治。[ Objective ] To evaluate the clinical results of posterior hemivertebra resection and correction with transpedicular instrumentation for congenital scoliosis. [ Method ] From July 2002 to December 2006, thirty - nine consecutive cases, including 22 males and 17 females, underwent posterior hemivertebra resection and correction using transpedicular instrumentation. The average age at surgery was 8.3 years ranging from 3 to 15 years. There were 30 cases with fully segmented hemivertebra and 9 cases with partial segmented hemivertebra. Instrument included 16 cases of ISOLA, 10 cases of CD -Horizon, 10 cases of Moss - Miami and 3 cases of TSRH. The pre - and post - operative standing radiographic and at final follow - up were measured, and the Cobb＇ s angles in the coronal and sagittal plane were analyzed, respectively. [ Result] The average follow - up was 2.8 years ranging from 1 to 4. 5 years. The Cobb＇s angle in coronal plane was corrected from 48° to 13°postoperatively and 13.2° at final follow - up, representing 70. 2% correction rate. The kyphosis was corrected from 39° to 12. 1 ° postoperatively and 12.7° at final follow - up, representing 68.7% correction rate. All cases had bony fusion, there was no neurological complication, no implant failure or infection. One case had crankshaft phenomenon. [ Conclusion ] Posterior hemiveterbra resection with instru mentation is a safe and effective treatment option for congenital scoliosis. Congenital scoliosis should be treated in early age.

关 键 词：先天性脊柱侧凸 半椎体畸形 半椎体切除 器械内固定 

分 类 号：R687.3[医药卫生—骨科学]