陈旧性胸腰椎骨折并后凸畸形截骨矫形的治疗效果观察  

The therapeutic effect of osteotomy for the treatment of patients with the spinal sagittal kyphotic deformity in old thoracolumbar fracture

作　　者：苏高 孙建广[1] 罗成汉[1] 黄世磊[1] 李峰[1] 皮国富[1] Su Gao;Sun Jianguang;Luo Chenghan;Huang Shilei;Li Feng;Pi Guofu(Department of Orthopedic,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院骨科,河南郑州450000

出　　处：《河南医学研究》2018年第4期601-604,共4页Henan Medical Research

摘　　要：目的比较经椎弓根椎体截骨(PSO)与经椎间隙楔形截骨(IWO)对陈旧性胸腰段脊柱后凸畸形患者矢状面平衡重建的效果。方法回顾性分析2011年9月至2016年10月20例行PSO或IWO矫形内固定术的陈旧性胸腰段脊柱后凸畸形患者资料。其中PSO组10例(男3例,女7例),年龄为53~68岁,平均Cobb角(37.20±8.71)°;IWO组10例(男2例,女8例),年龄为49~75岁,平均Cobb角(35.07±9.43)°。所有患者随访时间均在1 a以上。测量患者术前、术后及末次随访时矢状面Cobb角、Oswestry功能障碍指数(ODI)及视觉模拟评分(VAS)。结果所有患者的矢状面参数(Cobb角、ODI评分、VAS疼痛评分)术前、术后和末次随访相互比较,差异有统计学意义(P<0.05)。两组患者的矢状面参数(Cobb角、ODI评分和VAS疼痛评分)术前、术后及末次随访中比较,差异无统计学意义(P均>0.05)。结论 PSO和IWO均能有效重建陈旧性胸腰段脊柱后凸畸形的矢状面形态并获得良好的临床效果。Objective To explore the surgical efficacy of pedicle subtraction osteotomy and intervertebral wedge osteotomy for the treatment of patients with the spinal sagittal kyphotic deformity in old thoracolumbar fracture.Methods A retrospective analysis was performed from September of 2011 to October of 2016 in 20 patients with the spinal sagittal kyphotic deformity in old thoracolumbar fracture who underwent PSO or IWO.The PSO group:10 patients(3 males and 7 females),aged 53 to 68 years,mean Cobb angle(37.20±8.71)°.IWO group:10 patients(2 males and 8 females),aged 49 to 75 years,mean Cobb angle(35.07±9.43)°.All cases treated by PSO or IWO were followed up for more than 1 year.The sagittal Cobb angle,the oswestry disability index and the visual analog scale of patients with the spinal sagittal kyphotic deformity in old thoracolumbar fracture were evaluated at pre-operation,post-operation and the last follow-up.Results The patients’sagittal parameters(Cobb angle,ODI and VAS)were significantly different among pre-operation,post-operation and the last follow-up(P<0.05).However,there were no significant differences at sagittal parameters(Cobb angle,ODI and VAS)between PSO and IWO groups in pre-operation,post-operation and the last follow-up(P>0.05).Conclusion The sagittal balance of patients with the spinal sagittal kyphotic deformity in old thoracolumbar fracture could be well restored by either PSO or IWO,and both of them could obtain a good biomechanics and surgical efficacy.

关 键 词：陈旧性胸腰椎骨折 后凸畸形 截骨术 

分 类 号：R683.7[医药卫生—骨科学]