经后路椎弓根截骨内固定治疗老年严重脊柱后凸畸形  

Treatment of senile thoracolumbar kyphotic deformity by posterior pedicle subtraction osteotomy and internal fixation

作　　者：陈建梅[1,2] 姚晓东[1,2] 黄丽花[1,2] 徐皓[1,2] 

机构地区：[1]福建医科大学福总临床医学院 [2]南京军区福州总医院骨科,福建福州350025

出　　处：《临床骨科杂志》2013年第4期365-367,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨后路经椎弓根截骨治疗老年严重脊柱后凸畸形的临床疗效。方法对18例老年严重脊柱后凸畸形患者采用后路经椎弓根截骨矫形内固定治疗,分别于术后2周、3个月、12个月通过X线片、VAS评分、Cobb角、神经功能恢复情况评估临床疗效。结果 18例均获随访,时间14～37个月。VAS评分:术前8.4分±1.3分,术后2周、3个月、12个月分别为1.1分±0.3分、1.1分±0.2分、1.2分±0.3分,与术前比较差异均有统计学意义(P<0.05)。Cobb角:术前为78.3°±5.9°,术后2周、3个月、12个月分别为42.7°±8.4°、42.9°±5.7°、44.2°±6.9°,与术前比较差异均有统计学意义(P<0.05)。有2例发生硬脊膜撕裂,1例直接缝合,1例行脑膜片修补,未发生脑脊液漏。无内固定松动、断裂及截骨面假关节形成。结论后路经椎弓根截骨矫形内固定可以有效矫正老年性脊柱后凸畸形,临床疗效良好。Objective To evaluate the effect of posterior pedicle subtraction osteotomy and internal fixation for senile thoracolumbar kyphotic deformity. Methods 18 cases of senile thoracolumbar kyphotic deformity treated in our hos- pital were retrospectively analyzed. All cases were treated with posterior pedicle subtraction osteotomy and internal fixation. Clinical effects were evaluated by X-ray, VAS score, Cobb＇s angle, nerve functional rehabilitation. Results The follow-up period was 14 - 37 months. The VAS score was 8.4 ± 1.3 preoperatively, and was 1.1 ± 0. 3,1.1 ±0. 2, 1.2 ±0. 3 at 2 weeks, 3months, 1 year postoperatively respectively. The difference was significant between pre- operation and postoperation（P 〈0. 05）. The Cobb＇s angle was 78. 3° ±5.9° preoperatively, and was 42. 7°±8.4°, 42. 9° ± 5.7° ,44. 2° ± 6. 9° at 2 weeks ,3months, 1 year postoperatively respectively. The difference was significant between preoperation and postoperation（ P 〈 0. 05 ）. Spinal dura matter tearing occun＇ed in 2 patients and was repaired during operation. No leakage of cerebrospinal fluid was found post-operation. No implaat subsidence, excursion or pseudoarthrosis was found in all patients. Conclusions Posterior osteotomy and internal fixation are effective technique for senile thoracolumbar kyphotic deformity.

关 键 词：脊柱后凸 截骨 椎弓根 老年人 内固定 

分 类 号：R682.3[医药卫生—骨科学] R687.3[医药卫生—外科学]