一期经后路节段性椎弓根螺钉系统治疗NF-1型神经纤维瘤病脊柱畸形的临床疗效  

Clinical efficacy of one stage posterior segmental pedicle screw system in the treatment of spinal deformity of NF-1 neurofibromatosis

作　　者：王喆[1] 崔波[1] 方子乔 陈骞[1] 池琦[1] 张玲玲[1] Wang Zhe;Cui Bo;Fang Ziqiao;Chen Qian;Chi Qi;Zhang Lingling(Department of Orthopedics Ward,General Hospital of FuShun Mining Bureau of Liaoning Province,Liaoning Fushun 113000,China)

机构地区：[1]抚顺矿务局总医院骨科一病房,辽宁抚顺113000

出　　处：《现代肿瘤医学》2019年第9期1601-1606,共6页Journal of Modern Oncology

摘　　要：目的:探讨一期经后路节段性手术,采用椎弓根螺钉系统治疗NF-1型神经纤维瘤病脊柱畸形,术后是否可以获得满意疗效。方法:选取符合NF-1型神经纤维瘤病的诊断标准,并在抚顺矿务局总医院行一期经后路节段性手术,采用椎弓根螺钉系统治疗的20例病例,分别给予术前、后,末次随访,立位脊柱X线平片摄影,测出冠、矢状面的Cobb角度,并关注躯干平衡疗效(测量顶椎距骶正中线、躯干偏移、髂棘高度差、双肩高度差),统计学分析冠、矢状面的Cobb角度及躯干平衡疗效的变化规律。结果:所选病例中冠状面、矢状面术后即时疗效及末次随访疗效较好(P<0.001),随访中冠状面发现自发矫正(P<0.01),矢状面未发现自发矫正(P>0.05);躯干平衡疗效:顶椎距骶正中线距离术后即时疗效较好(P<0.001),末次随访疗效较好(P<0.001);躯干偏移术后即时疗效较差(P>0.05),末次随访疗效较好(P<0.01);X线髂棘高度差术后即时疗效较差(P>0.05),末次随访疗效较差(P>0.05);X线双肩高度差术后即时疗效较好(P<0.01),末次随访疗效较好(P<0.01);以上随访中均未发现自发矫正(P>0.05)。结论:一期经后路节段性手术,采用椎弓根螺钉系统治疗NF-1型神经纤维瘤病脊柱畸形,术后可以获得满意疗效。Objective:To investigate the efficacy of posterior pedicle screw system in the treatment of NF-1 neurofibromatosis spinal malformation after operation.Methods:The diagnostic criteria consistent with neurofibromatosis type NF-1,and after a period after the surgery of General Hospital of Fushun Mining Bureau,posterior segmental,using pedicle screw system in the treatment of 20 cases were given before and after operation,at the end of the follow-up,orthostatic spinal X-ray photography,measured coronal and sagittal Cobb angle,and focus on trunk balance effect(measured from the top of the sacral vertebral midline,trunk shift,iliac crest height difference and shoulder height difference),statistical analysis of the change regularity of coronal and sagittal Cobb angle and trunk balance effect.Results:All the cases in the coronal and sagittal had well postoperative curative effect and follow-up curative effect(P<0.001),coronal follow-up found spontaneous correction(P<0.01),sagittal plane found no spontaneous correction(P>0.05).Trunk balance effect:The apical sacral midline distance from the immediate postoperative curative effect was better(P<0.001),the last follow-up effective(P<0.001).Poor instant effect of trunk shift after operation(P>0.05),at the end of the follow-up curative effect(P<0.01).Poor X-ray instant effect of iliac crest height difference after operation(P>0.05),at the end of the follow-up treatment(P>0.05).X-ray shoulder height difference of postoperative immediate effect was good(P<0.01),at the end of the follow-up curative effect(P<0.01).Follow-up was not found in spontaneous correction(P>0.05).Conclusion:The pedicle screw system is used to treat the spinal deformities of neurofibromatosis NF-1 by posterior segmental surgery,and the satisfactory results can be obtained after the operation.

关 键 词：NF-1型神经纤维瘤病 脊柱畸形 椎弓根螺钉系统 

分 类 号：R739.4[医药卫生—肿瘤]