凹侧双棒全椎弓根螺钉技术对提高重度僵硬性特发性脊柱侧凸矫治效果的作用  

Correction effect of concave-side operation with double-rod pedicle screw on severe and rigid idiopathic scoliosis:a clinical study

作　　者：贾全章[1] 孙景海[1] 侯明晓[1] 徐爽[1] 卞传华[1] 张志刚[1] 苗旭曼[1] 王宇[1] 陈阳[1] 许建中[2] 杨滔[2] 

机构地区：[1]解放军第208医院全军骨科中心,长春130062 [2]第三军医大学西南医院全军矫形外科中心

出　　处：《解放军医学杂志》2009年第6期683-685,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨凹侧双棒全椎弓根螺钉技术对重度僵硬性特发性脊柱侧凸矫治效果的影响。方法回顾性分析2004年6月-2008年12月施行手术矫治的重度僵硬性特发性脊柱侧凸患者37例,其中男12例,女25例,年龄14～38岁,平均17岁。18例采用后路凹侧双棒全椎弓根螺钉法矫治脊柱侧凸(实验组),19例采用常规后路钉棒法(对照组),比较两组的手术时间、出血量以及手术前后的站立位主侧凸冠状面Cobb角、主侧凸顶椎偏距、身高等指标。结果平均随访18个月,实验组主侧凸冠状面Cobb角矫正率平均为51.2%,对照组为42.0%,实验组主凸顶椎偏距矫正率平均为41.1%,对照组为36.2%,身高增长实验组平均为6cm,对照组为3cm,以上指标两组间比较均有显著性差异(P<0.05)。两组手术时间、出血量比较无明显差异(P>0.05)。结论凹侧双棒全椎弓根螺钉法可提高重度僵硬性特发性脊柱侧凸的矫正率,安全可靠。Objective： To investigate the influence of concave-side fixation with double-rod pedicle screw on correction effect of severe and rigid idiopathic scoliosis. Methods Clinical data of 37 patients with severe and rigid idiopathic scoliosis （12 males and 25 females, aged 14-38 with average of 17 years, admitted from Jun. 2004 to Dec. 2008） were retrospectively studied. Concave-side fixation with double-rod pedicle screw were performed in 18 cases （study group）, while 19 patients （control group） were corrected by routine posterior pedicle screw-rod fixation. The parameters were compared between the two groups of operative time, blood loss, coronal Cobb angle of the major curves in standing position, apical vertebral translation, and body height before and after operation. Results All the patients were followed up averagely for 18 months （ranged 6-30 months）. The mean correction rate of major curve Cobb angle, apical vertebral translation and the increment of body height were 51.2%, 41. 1% and 6cm, respectively, in study group, and 42. 0%, 36. 2% and 3cm, respectively, in control group. Statistical differences existed on the three parameters between the two groups （P〈0. 05）. However, there wasno significant difference on operation time and blood loss between the two groups （P〉0. 05）. Conclusion The concave-side fixation with double-rod pedicle screw may increase the correction rate and is safe for severe and rigid idiopathic scoliosis.

关 键 词：脊柱侧凸 内固定器 矫形外科手术 

分 类 号：R681.5[医药卫生—骨科学]