Ⅰ期PVCR加重建术治疗脊柱后凸畸形  

Treatment of spinal kyphosis with posterior vertebral column in one stage

作　　者：杨泽龙[1,2] 蒋婷[3] 冯大雄[4] 冯刚[1,2] 

机构地区：[1]川北医学院第二临床学院 [2]南充市中心医院骨科 [3]烧伤整形美容科,四川南充637000 [4]泸州医学院附属医院骨科,四川泸州646000

出　　处：《西部医学》2015年第8期1150-1153,共4页Medical Journal of West China

基　　金：国家自然科学基金(81301568)

摘　　要：目的总结经后路Ⅰ期全椎体切除（posterior vertebral column resection,PVCR）加重建治疗脊柱后凸畸形的经验。方法回顾性分析我院2008年6月至2012年8月经后路Ⅰ期全椎体切除加重建术治疗53例脊柱后突畸形患者的临床资料。测量手术前、后及随访时的Cobb’s角、C7-S1垂线间距离、Frankel分级、Oswestry功能障碍指数（ODI值）。结果随访18～36月,平均（26±2.5）月;脊柱后凸Cobb’s角术前（92.7±18.6）°,术后一周为（21.3±5.2）°,末次随访时为（24.1±5.6）°,矫正率77.0%,矫正无明显丢失（P〉0.05）;C7-S1垂线间距离术前（15.3±4.9）mm,术后（3.6±2.3）mm,矫正率76.4%,末次随访时为（4.5±2.1）mm,矫正无明显丢失（P〉0.05）;术前伴有神经损伤症状者8例,从发生神经症状到就诊的平均时间（14±7）天,Frankel术前分级：B级2例、C级3例、D级3例,术后末次随访都恢复到E级;ODI指数：术前（20.8±5.3）分,末次随访（8.8±2.3）分,平均改善率为57.7%。结论 PCVR加重建术治疗严重脊柱后凸畸形安全、有效,其矫形效果满意、并发症少、脊髓及神经根减压充分。Objective To evaluate the results and summary the treatment experience of posterior vertebral column resection （PVCR） for spinal kyphosisi in one stage. Methods The clinical data of 53 patients who susfered from spinal kyphosis treated with posterior vertebral column resection in one stage were retrospectively analyzed. The Cobb＇s Angle, C7-S1 perpendicular distance, Frankcl Grade for neurological deficits and Oswestry Disability Index （ODI） were evaluated preoperatively and postoperatively. Results The follow-up time was 18 to 36 months, average 26±2.5 months. The average Cobb＇s Angle of spinal kyphosis was （92.7 ± 18. 6）° before surgery and （21.3 ±5.2） ° in one week after surgery. The correction rate was 77.0%. The average Cobb＇s Angle of spinal kyphosis was （24.1±5.6）° at the final follow-up. The corrected kyphosis was not lost distinctly （P〈0. 05）. The average C7-S1 perpendicular distance was （15.3±4.9） mm before surgery and （3.6±2.3）mm in one week after surgery. The correction rate was 76.4%. The average C7-S1 perpendicular distance was （4.5 ± 2.1）mm at the final follow-up. The corrected kyphosis was not lost distinctly （P〈 0. 05）. There are 8 cases with nerve injury symptom before surgery. The average time from appearing nerve injury symp- tom to treatment was 14±7 days. The Feankel Grading for neurological function were B in 2 cases, C in 3 cases and D in 3 cases preoperatively, and E in 13 cases at the final follow-up. The average Oswestry Disability Index（ODD was 20.8± 5.3 before surgery and 8. 8 ±2.3 at the final follow-up, with an average improvement rate was 57.7%. Conclusion PVCR and reconstruction is a safe and effective way for correction of kyphosis, less complications, spinal and nerve root decompressing sufficiently in the surgical treatment of severe spinal kyphosis.

关 键 词：脊柱后凸 截骨术 PVCR 脊柱重建术 

分 类 号：R682.3[医药卫生—骨科学]