成人脊柱后凸畸形后路全脊椎截骨矫形手术1200例报告  

Long-term follow-up of whole vertebrae osteotomy to correct spinal deformity through posterior incision-a report of 1200 cases

作　　者：王正雷[1] 高吉昌[1] 贾丹兵[1] 唐立明[1] 张文进[1] 孙鹏[1] 刘建辉[1] 宫明[1] 吴显宇[1] 范文宪[1] 赵福权[1] 郭宁[1] 齐琦[1] 

机构地区：[1]解放军第211医院骨科,哈尔滨150080

出　　处：《中国矫形外科杂志》2011年第15期1258-1260,共3页Orthopedic Journal of China

摘　　要：[目的]总结成人脊柱后凸畸形后路全脊椎截骨矫形手术方式。[方法]通过后方入路经双侧椎弓根、椎体行楔形截骨,直到椎体前缘皮质下,并行椎弓根钉棒系统内固定。[结果]共手术矫正后凸及侧后凸畸形1 200例,其中男938例,女262例;发病时间5.6～28年,平均11.6年;年龄15～52岁,后凸畸形时间2.5～26年,平均7.3年。后凸病因:强直性脊柱炎后凸畸形720例;脊柱压缩性骨折246例;脊柱结核132例;先天性脊柱后凸畸形59例;休门氏病后凸43例。最高截骨平面T9水平,单病例最多截骨达4处,平均截骨2处,一处椎体截骨时间平均30 min,出血约100 ml,术中脊髓和神经根保护安全。[结论]成人脊柱后凸畸形后路全脊椎截骨矫形手术截骨规范充分、手术时间短、术中出血少、脊髓和神经根保护安全、截骨创面对合紧密、利于截骨创面愈合。适用于各种原因导致的脊柱后凸畸形截骨矫正手术,显著降低术中和术后并发症。[Objective] To summary the whole vertebrae osteotomy of adults to correct scoliosis and kyphoscoliosis. [Methods]Through posterior transpedicular and vertebrae,wedged osteotomy was continually performed till anterior substantia compacta of vertebrae. [Results]More than 1 200 patients with scoliosis or kyphoscoliosis were treated with the method,including male 938 cases,female 262 cases,onset time 5.6 ～ 28 years,average 11.6 years.Patients aged 15～52 years,with scoliosis time 2.5～26 years,average 7.3 years.Scoliosis causes： ankylosing spondylitis scoliosis in 720 cases,compressive fracture in 246 cases,spinal tuberculosis in 132 cases,congenital rachis deformity in 59 patients,hugh door Addison＇s disease of the scoliosis in 43 cases.The highest osteotomied vertebrae was L9 and 4 levels were performed in 1 case（mean 2 levels）.The average time of osteotomy on one vertebrae was 30 min companied with 100 ml blood loss.No spine and spinal root injury was detected during the operating procedure. [Conclusion]Adult rachis posterior spinal deformity whole osteotomies orthopaedic surgery could reduce operating time,blood loss,keep spine and spinal root safer during the operating procedure.It can also make osteotomical plate fit well and prompt quick ossification,significantly reduce intraoperative and postoperative complications.

关 键 词：脊柱后凸畸形 后路全脊椎截骨 矫形手术 

分 类 号：R687.3[医药卫生—骨科学]