单侧生长棒技术治疗早发性脊柱侧凸的近期临床疗效研究  

Single growing rod technique for the treatment of early - onset scoliosis:a study of the clinical efficacy

作　　者：邓盎[1] 张宏其[1] 郭超峰[1] 唐明星[1] 刘少华[1] 王昱翔[1] 高琪乐[1] 吴建煌[1] 刘金洋[1] 

机构地区：[1]中南大学湘雅医院脊柱外科、湘雅脊柱外科中心,长沙市410008

出　　处：《中国矫形外科杂志》2013年第5期448-454,共7页Orthopedic Journal of China

基　　金：湖南省科技厅科技计划重点项目(编号:2009sK2012);湖南省“芙蓉学者计划”资助项目;中央高校基本科研业务费专项资金资助项目(编号:2012QNZT126)

摘　　要：[目的]探讨单侧生长棒技术治疗早发性脊柱侧凸的近期临床疗效。[方法]2005年1月～2011年6月应用三维矫形系统治疗各型脊柱侧凸727例,其中应用椎弓根螺钉系统的单侧生长棒技术治疗的12例早发性脊柱侧凸患儿,测量初次手术前、后,末次术后随访或终末手术后的主弯冠状面Cobb角、柔韧性、侧凸矫正率、胸椎后凸角、腰椎前凸角、躯干偏移、矢状面平衡、T_1～S_1高度和T_1～S_1生长速度。[结果]平均随访28.8(10.9～49.2)个月。初次手术前主弯冠状面Cobb角(72.8±15.7)°、柔韧性(35.34±10.71)%、胸椎后凸角(39.9±15.8)°、腰椎前凸角(46.2±13.8)°、躯干偏移(1.29±0.93)cm、矢状面平衡(1.96±1.10)cm、T_1～S_1高度(24.46±3.77)cm;初次手术后主弯冠状面Cobb角(34.9±9.1)°、侧凸矫正率(52.01±7.69)%、胸椎后凸角(31.3±11.2)°、腰椎前凸角(46.1±5.9)°、躯干偏移(0.50±0.29)cm、矢状面平衡(1.32±1.19)cm、T_1～S_1高度(29.22±4.05)cm;末次术后随访或终末手术后主弯冠状面Cobb角(30.8±12.5)°、侧凸矫正率(57.92±14.80)%、胸椎后凸角(29.5±7.4)°、腰椎前凸角(48.8±5.7)°、躯干偏移(0.39±0.24)cm、矢状面平衡(0.79±0.45)cm、T_1～S_1高度(31.72±4.68)cm。共撑开1～4次,平均1.9次。后续撑开期间T_1～S_1生长速度(1.26±0.60)cm/年。未见严重并发症发生。[结论]单侧生长棒技术治疗早发性脊柱侧凸可获得较满意的矫形效果和脊柱纵向生长。[ Objective] To study the clinical efficacy of single growing rod technique for the treatment of early - onset scol- iosis （EOS） . [ Methods] From January 2005 to June 2011, 12 patients with EOS underwent single growing rod surgery using pedicle screw system in our department. Analysis included measured coronary Cobb angle, flexibility, correction rate, thoracic kyphosis angle （TKA）, lumbar lordosis angle （LLA）, trunk shift （TS）, sagittal vertical axis （SVA）, length of Tt -St and growth speed of Tt -St before initial surgery, after initial surgery, and at the last follow -up or post -final -fusion. [ Results] The mean follow - up period was 28. 8 months （ range, 10. 9 - 49. 2 months） . Coronary Cobb angle was （72. 8 ± 15.7） °, flexi- bilitywas （35.34±10.71）%, TKAwas （39.9±15.8）°, LLAwas （46.2±13.8）°, TSwas （1.29±0.93） cm, SVAwas （ 1.96 ± 1.10） cm, length ofT1 - St was （24. 46 ±3.77） cm before initial surgery; Coronary Cobb angle was （34. 9 ±9. 1 ） °, correction rate was （52.01 ± 7.69） %, TKA was （31.3 ± 11.2） °, LLA was （46.1 ± 5.9） ° TS was （0. 50 ± 0.29） cm, SVA was （ 1.32 ± 1.19） cm, length of T1 - S1 was （29. 22 ± 4. 05 ） cm after initial surgery; Coronary Cobb angle was （30. 8 ± 12. 5）°, correction rate was （57. 92 ± 14. 80）%, TKA was （29. 5 ±7.4）°, LLA was （48. 8 ±5.7）°, TS was （0. 39 ±0. 24 ） cm, SVA was （0. 79 ±0.45） cm, length of T1 - St was （31.72 ±4. 68） cm at the last follow - up or post - final - fusion. All patients underwent 1 -4 times of lengthening procedures （ mean, 1.9 times） . The growth speed of T1 - S1 was （ 1.26 ±0. 60） cm/yr during the distraction period. There were no severe complications. [ Conclusion ] Single growing rod technique for thetreatment of EOS is safe and effective with satisfactory correction and spinal growth.

关 键 词：生长棒  早发性脊柱侧凸  矫形  脊柱生长 

分 类 号：R687.3[医药卫生—骨科学]