蛋壳截骨技术治疗强直性脊柱炎后凸畸形的近期疗效  

Short-term therapeutic effect of eggshell technique in the treatment of kyphotic deformity in ankylosing spondylitis

作　　者：熊廷亮[1,2] 林宏生[1,2] 吴昊[1,2] 张国威[1,2] 

机构地区：[1]暨南大学附属第一医院骨科 [2]暨南大学骨科研究所,广东广州510632

出　　处：《暨南大学学报（自然科学与医学版）》2013年第6期649-654,共6页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：卫生部科技发展中心基金项目(W2013ZT083);暨南大学附属第一医院科研培育基金项目(2013101)

摘　　要：目的：探讨“蛋壳”截骨技术在治疗强直性脊柱炎后凸畸形中的短期临床疗效。方法：29例强直性脊柱炎后凸畸形患者，根据术前测量的后凸Cobb角、颌眉垂线角，分别采用后路经L 1、L 2或L 3椎弓根的蛋壳截骨技术，其中1例因T9压缩性骨折而行T9截骨矫形。结果：手术时间为200～345 min，出血量为900～2300 mL，无神经系统并发症发生；Cobb角由术前的平均70.1°矫正为术后的平均38.3°，颌眉垂线角由术前的平均39.0°矫正为术后的平均6.0°；所有患者能够平视行走，步态得到明显改善，随访中截骨平面均获骨性融合，无断钉及内固定失效发生。结论：“蛋壳”截骨技术，能够在充分保护脊髓和神经根的前提下实现椎体的楔形截骨，对于强直性脊柱炎后凸畸形具有良好的治疗效果。Aim：To investigate the Short-term clinical theraputic effect of“eggshell”technique of ver-tebra osteotomy for treatment of kyphosis deformity caused by ankylosing spondylitis.Methods：Twenty-nine patients with ankylosing spondylitis kyphotic deformity received surgical treatment.The eggshell technique osteotomy was performed through L1、L2 or L3 vertebrae according to the preoperative Chin-brow vertical angle.One for T9 compressibility fracture,The eggshell technique osteotomy was performed through T9 vertebrae.Results：All the patients stood surgery well.The time were 200~345 min and the bleeding loss during operation were 900 ~2 300 mL.There was no postoperative neurologic complication and no breakage of nails or failure of the internal fixation during the follow up period.The mean Cobb Angle was corrected from preoperative 70.1 °to postoperative 38.3°.The mean Chin-brow vertical angle was corrected from preoperative 39.0°to postoperative 6.0°.All patients can walk with forward vision, the gait was improved significantly.Conclusion：Eggshell technique is effective for managing kyphosis in ankylosing spondylitis.It can provide good protection for spinal cord and nerve roots.

关 键 词：蛋壳技术 强直性脊柱炎 截骨 后凸畸形 

分 类 号：R687.31[医药卫生—骨科学]