后路全脊椎切除矫形手术治疗陈旧结核性脊柱后凸畸形的效果及并发症  

Therapeutic effect and complications of posterior vertebral column resection orthopaedic surgery on obsolete tuberculous kyphosis of spine

作　　者：韩小锋 郭团茂 HAN Xiao-feng;GUO Tuan-mao(the Fourth People＇s Hospital of Shaanxi Province,Xi＇an 710043;Xianyang Central Hospital,Xianyang 712000,China)

机构地区：[1]陕西省第四人民医院,陕西西安710043 [2]咸阳市中心医院,陕西咸阳712000

出　　处：《临床医学研究与实践》2018年第34期20-21,共2页Clinical Research and Practice

基　　金：咸阳市2016年科学技术研究计划项目(No.2016K02-99)

摘　　要：目的探讨后路全脊椎切除矫形手术治疗陈旧结核性脊柱后凸畸形的疗效及并发症。方法随机选择2014年8月至2017年1月医院收治的陈旧结核性脊柱后凸畸形患者53例作为研究对象,将其分为PSO组(后凸畸形角度≤70°,n=23)和VCR组(后凸畸形角度>70°,n=30)。PSO组行后路经后凸顶点截骨+前方撑开或闭合矫形-后方闭合矫形(PSO),VCR组行后凸融合节段切除截骨+双轴旋转矫形+前柱重建(VCR),观察两组患者治疗前、后后凸畸形角度调整情况、ODI评分及并发症发生情况。结果治疗后,两组患者后凸角畸形角度、ODI评分均降低(P<0.05);53例患者中术后短期脊髓功能障碍5例,下肢感觉运动能力降低2例,随访1年内后凸畸形复发2例。结论针对陈旧结核性脊柱后凸畸形患者,需根据其严重程度选择合理术式,并做好并发症的预防工作,确保患者恢复效果。Objective To investigate the effect and complications of posterior vertebral column resection orthopaedicsurgery on obsolete tuberculous kyphosis of spine. Methods A total of 53 patients with obsolete tuberculous kyphosis ofspine admitted in the hospital from August 2014 to January 2017 were randomly selected as study objects, and the patientswere divided into PSO group （kyphosis angle〉70°, n=23） and VCR group （kyphosis angle≤70°, n=30）. The PSO groupwas treated with posterior convex vertex osteotomy＋anterior open or closed orthosis-posterior closed orthosis （PSO）, whilethe VCR group was treated with posterior convex fusion segmental resection of osteotomy ＋biaxial rotary orthopaedic＋anterior column reconstruction （VCR）. The adjustment of kyphosis angle, ODI scores and occurance of complications beforeand after treatment were observed between the two groups. Results After treatment, the kyphosis angle and ODI scores ofthe two groups decreased significantly （P〈0.05）. Among the 53 patients, 5 cases had short-term spinal cord dysfunctionpostoperative,2 cases had lower limb sensorimotor ability reduced, and 2 cases had kyphosis recurrence within 1 yearfollow-up. Conclusion For patients with obsolete tuberculous kyphosis of spine, reasonable operative methods should beselected according to the severity of patients, and the prevention of complications should carry out to ensure the recovery ofpatients.

关 键 词：陈旧结核性脊柱后凸畸形 PSO VCR 

分 类 号：R687.3[医药卫生—骨科学]