颅盆牵引软组织松解加后路手术治疗重度脊柱侧弯36例观察  

Observation on Posterior Surgery and Halo Pelvic Distraction for Soft Tissue Release in the Treatment of Severe Spinal Scoliosis

作　　者：黄朝国[1] 梁益建[1] 石化洋[1] 胡正军[1] 

机构地区：[1]成都市第二人民医院,四川成都610017

出　　处：《现代临床医学》2012年第1期54-56,共3页Journal of Modern Clinical Medicine

摘　　要：目的:评价颅盆环牵引软组织松解加脊柱后路手术治疗重度脊柱侧弯畸形的临床疗效。方法:回顾性分析颅盆牵引软组织松解加后路手术治疗重度脊柱侧弯36例的临床资料。36例患者均行颅盆环牵引,牵引过程中行凹侧软组织松解-胸廓成形术,经牵引脊柱畸形得到较理想矫正后行脊柱后路手术植骨融合内固定。治疗前后测量患者脊柱侧弯Cobb’s角及身高,分别比较治疗前后的差异性。结果:36例患者均顺利完成手术,患者脊柱侧弯Cobb’s角由手术前的(95.9±28.4)°矫正至(35.2±12.3)°,矫正率63.3%;身高由手术前的132.7±15.4 cm增高至146.7±15.4 cm,手术前后比较有显著性差异(P<0.05)。患者身体外形、行走姿势得到明显的改善,脊柱额状面失平衡得到明显的纠正。本组病例无脊髓神经损伤及肠系膜上动脉综合征等严重并发症发生。结论:对于重度脊柱侧弯患者,经颅盆环牵引凹侧软组织松解-胸廓成形术加后路手术治疗,可以提高患者手术耐受性,简化操作,预防并发症的发生,是一种安全有效的治疗方法。Objective： To evaluate the clinical effectiveness of Halo pelvic distraction for soft tissue release after posterior surgery in treatment of severe spinal deformity. Methods：36 patients with severe spinal deformity were treated with following procedures： Halo pelvic distraction, bank concave side soft tissue release and thoracoplasty during pulling if necessary, posterior interbody fusion surgical correction of the traction deformity, and interbody fixation by the ideal pedicle screw - rod system. The difference in the Cobb＇ s angle and height in patients with scoliosis were measured before and after treatment, respectively. Resuils：36 patients were successfully treated, with a correction rate of 63. 3%. The Cobb＇ s angle was （95. 9 ± 28.4 ）°before treatment and （35. 2 ± 12. 3）° after treatment, respectively. The height was 132. 7 ± 15.4 cm before treatment and 146. 7 ± 15.4 cm after treatment, respectively. The difference in Cobb＇ s angle and height was statistically significant before and after treatment （ P 〈 0.05 ）. The patients＇ body shape, walking posture, shoulders and penis balance were significantly improved. Neither spinal cord injury nor superior mescenteric artery syndrome was observed. Conclusion：Halo pelvic distraction for the concave side soft tissue release technique, thoracoplasty, pulling, and posterior interbody fusion fixation surgery, provide an effective approach to treating severe seoliosis. It simplifies operation, improves patient surgical tolerance, and prevents complications.

关 键 词：脊柱弯曲畸形 颅盆牵引 Cobb’s角 简化操作 

分 类 号：R682.3[医药卫生—骨科学]