传统生长棒治疗特发性早发性脊柱侧凸的早期疗效  

Analysis on early clinical outcomes of traditional growing rod for idiopathic early-onset scoliosis

作　　者：李伟[1] 童国军 蔡兵兵 全仁夫[1] Li Wei;Tong Guojun;Cai Bingbing;Quan Renfu(Department of Orthopaedics,Jiangnan Hospital Affiliated to Zhejiang Chinese Medical University,Traditional Chinese Medical Hospital of Xiaoshan,Hangzhou 311201,China)

机构地区：[1]浙江中医药大学附属江南医院,市萧山区中医院,杭州311200

出　　处：《中华骨科杂志》2021年第12期755-762,共8页Chinese Journal of Orthopaedics

摘　　要：目的探讨采用传统生长棒治疗特发性早发性脊柱侧凸(idiopathic early-onset scoliosis,IEOS)的早期疗效。方法回顾性分析2017年2月至2018年12月手术治疗11例IEOS患者资料,男4例,女7例;第一次手术时年龄(6.45±1.63)岁(范围5~9岁);术前Cobb角74.74°±6.48°(范围66.12°~87.85°)。分析患者术前、术后即刻、术后1个月、术后1年及术后2年的Cobb角、T1~T12胸椎高度、T1~S1椎体高度、顶椎偏移距离(apical vertebral translation,AVT)、肺功能第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、用力肺活量(forced vital capacity,FVC),同时记录手术相关并发症。结果11例患儿均获得随访,随访时间(28.82±4.77)个月(范围23~37个月)。内固定初次置入术前Cobb角74.74°±6.48°,术后即刻降至30.30°±4.04°,术后1个月为30.39°±4.49°,术后1年为26.93°±3.09°,术后2年为28.36°±2.98°,术后2年矫正率为61.82%±4.85%;T1~T12胸椎高度术前(13.69±2.05)cm,术后即刻增加至(20.74±3.10)cm,术后1个月为(20.85±3.62)cm,术后1年为(21.49±3.56)cm,术后2年为(22.54±3.63)cm;T1~S1椎体高度术前(24.21±3.20)cm,术后即刻增加至(31.04±3.79)cm,术后1个月为(30.85±3.64)cm,术后1年为(32.91±3.24)cm,术后2年为(34.46±3.28)cm;AVT初次术前为(7.45±2.00)cm,术后即刻缩短为(2.04±0.67)cm,术后1个月为(2.07±0.70)cm,术后1年为(2.24±0.57)cm、术后2年为(2.11±0.82)cm。以上指标术前、术后1个月、术后1年、2年比较,差异均有统计学意义。与术前相比术后1年肺功能FEV1及FVC分别升高至(1.28±0.13)L和(1.49±0.10)L,术后2年分别升高至(1.34±0.13)L和(1.54±0.12)L。术后1年肺功能明显改善,并且肺功能FVC与T1~T12胸椎高度呈正相关(r=0.838,P<0.001)。11例患者发生13例次并发症,主要包括近端螺钉松动2例次、近端出现交界性后凸1例次、钛棒断裂1例次、内固定顶起皮肤3例次、皮下积液6例次,经及时治疗后均预后良好。结论传统生长棒�Objective To explore the early outcomes surgical treatment with growing rod for idiopathic early-onset scoliosis(IEOS).Methods Data of 11 patients with IEOS who had surgical treatment from February 2017 to December 2018 were retrospectively analyzed.There were 4 males and 7 females aged 6.45±1.63 at the time of the first operation,with preoperative Cobb angle of 74.74°±6.48°(range,66.12°-87.85°).The imaging data and clinical data before operation,after operation instantly,1 month after operation,1 year after operation and 2 years after operation,and surgical-related complications were analyzed and recorded.Results All the 11 patients were followed up for 28.82±4.77 months.The Cobb angle was 74.74°±6.48°before the initial implantation of internal fixation,and decreased to 30.30°±4.04°immediately after the operation,30.39°±4.49°1 month after the operation,26.93°±3.09°1 year after the operation,and 28.36°±2.98°2 years after the operation.The correction rate was 61.82%±4.85%2 years after operation.The height of T1-T12 thoracic vertebra was 13.69±2.05 cm before surgery,and increased to 20.74±3.10 cm immediately after surgery,and was 20.85±3.62 cm 1 month after surgery,21.49±3.56 cm 1 year after surgery,and 22.54±3.63 cm 2 years after surgery.The height of T1-S1 vertebral body was 24.21±3.20 cm before surgery,and increased to 31.04±3.79 cm immediately after surgery,and was 30.85±3.64 cm 1 month after surgery,32.91±3.24 cm 1 year after surgery,and 34.46±3.28 cm 2 years after surgery.Preoperative apical vertebral translation(AVT)was 7.45±2.00 cm before the initial operation,and shortened to 2.04±0.67 cm immediately after the operation,2.07±0.70 cm 1 month after the operation,2.24±0.57 cm 1 year after the operation,and 2.11±0.82 cm 2 years after the operation.There were statistically significant differences in the above indexes before surgery,1 month after surgery,1 year after surgery and 2 years after surgery.Compared with preoperation,pulmonary function FEV1 and FVC increased to 1.2

关 键 词：儿童 脊柱侧凸 矫形外科固定装置 

分 类 号：R687.3[医药卫生—骨科学]