经后路顶椎椎弓根全椎体截骨矫正胸腰椎后凸畸形  

Treatment of kyphosis deformity with pedicle subtraction osteotomy at the apical vertebra through posterior approach

作　　者：阮永平[1] 胡勇[1] 何贤峰[1] 徐荣明[1] 马维虎[1] 刘观焱[1] 顾勇杰[1] 

机构地区：[1]宁波市第六人民医院骨科,浙江315040

出　　处：《脊柱外科杂志》2009年第6期336-340,共5页Journal of Spinal Surgery

摘　　要：目的探讨经后路顶椎椎弓根三柱截骨治疗脊柱后凸的临床疗效。方法2003年6月－2006年6月，采用经后路顶椎椎弓根三柱截骨治疗42例脊柱后凸患者，其中陈旧胸腰椎骨折20例、椎体发育不良8例、结核性10例、强直性脊柱炎4例。评定脊柱后凸矫正情况、植骨融合情况、内固定位置、手术并发症、腰痛及Oswestry功能评分的变化。结果术后随访6—21个月，平均15个月。植骨融合满意，无延迟愈合或不愈合。术前后凸Cobb角度平均为霹8．5°术后为20．6°，平均矫正角度为35．3°。术前患者腰痛VAS评分平均为7．5分，术后3．6分。术前ODI平均为57．6％，术后31.7％。结论经后路顶椎椎弓根截骨、椎弓根螺钉固定治疗胸腰椎后凸畸形，矫正角度大，手术视野开阔，手术相对安全，可获得满意的放射学矫形效果和临床疗效。Objective To assess the clinical therapeutic effect of pedicle subtraction osteotomy at the apical vertebra through posterior approach for kyphosis deformity. Methods From June 2003 to June 2006, 42 cases of kyphosis deformity were treated with pedicle subtraction osteotomy at the apical vertebra. The kyphosis deformity was caused by old lumbothoracic fracture in 20 cases, vertebral dysplasia in 8 cases, spinal tuberculosis in 10 cases and ankylosing spondylitis in 4 eases. Preoperative and postoperative kyphotic Cobb＇ s angle, the fusion of bone graft, the position of internal fixation, the complications of operation, VAS of back pain and Oswestry disability index were assessedi Results The mean follow-up period Was 15 months, from 6 months to 21months. Satisfactory bone graft healing was achieved at final follow-up. Preoperative average Cobb＇ s angle was 48.5° and postoperative was 20.6°, with a mean correction of 35, 3° Preoperative average VAS of back pain was 7.5, and postoperative was 3.6. Preoperative average ODI was 57.6%, and postoperative was31.7% Concusion Pediele Subtraction osteotomy at the apical vertebra through posterior approach for kyphoslS deformity hasa satisfactory radiology Orthopedic effect and clinical therapeutic effect. It also offers a wide field of Vision field of vision, a high correction rate, and it is relative safe

关 键 词：胸椎 腰椎 脊柱后凸 截骨术 脊柱融合术 

分 类 号：R682.3[医药卫生—骨科学]