一期前后联合入路治疗重度颈椎后凸畸形一例报告及文献复习  

Severe cervical kyphosis treated by anterior and posterior approach:case report and literature review

作　　者：郑燕平 周超 王延国 Zheng Yanping;Zhou Chao;Wang Yanguo(Department of Spine Surgery,Qilu Hospital,Shandong University(Qingdao),Qingdao 266000,China)

机构地区：[1]山东大学齐鲁医院(青岛)脊柱外科,青岛266000

出　　处：《中华骨科杂志》2022年第3期182-187,共6页Chinese Journal of Orthopaedics

摘　　要：对重度僵硬性颈椎后凸畸形的手术治疗仍然是目前脊柱外科畸形治疗的难点之一,不管是一期矫形还是分期矫正以及截骨方式、截骨范围、截骨入路的选择意见并不一致。通过1例大角度僵硬性颈椎后凸畸形的诊治过程及相关文献回顾,期待得到进一步的认识和提高。女,23岁,因颈部畸形活动受限3年入院。通过颈椎X线片、CT、MR及CTA检查,显示颈椎后凸顶点为C_(3,4)椎间隙,后凸Cobb角为86°,柔韧性为8.1%,以及寰枢椎脱位并存在失稳;并评估颈椎分节、序列、椎弓根及侧块形态、椎动脉走行等情况。手术采用一期前后联合入路(手术顺序为前、后、前)实施颈椎椎间隙及寰枢椎松解、后方椎板关节突截骨、植骨融合完成畸形矫正。手术过程顺利,术后恢复颈椎前凸角至6.7°。术后随访4年,无围手术期及术后并发症发生,获得满意地矫形并维持良好。For the moment,the surgical treatment of severe rigid cervical kyphosis is still one of the difficulties in the treatment of spinal deformity.There were not consistent in the stage of correction,choice of osteotomy method,osteotomy scope and approach.In this paper,It was expected to get further understanding by sharing one case of severe cervical kyphosis treated by anterior and posterior approach,and reviewing literature.The patient was a 23-year-old female who had functional limitation due to cervical deformity for 3 years.It showed that the cervical kyphosis vertex was C_(3,4) segment,the Cobb angle was 86°,the flexibility was 8.1%,and the atlantoaxial vertebra was dislocated and unstable by the examination of X-ray,MRI,CT and CTA examination.The cervical segmental,sequence,morphological characteristics of pedicle and lateral mass,and running of the vertebral artery were also evaluated.The deformity was corrected by a one-stage operation combined anterior and posterior approaches for intervertebral and atlantoaxial release,osteotomy of the posterior lamina articular process and fusion with bone grafting.The cervical lordosis angle was recovered to 6.7°.The patients were followed up for 4 years.There were no operative and perioperative complications and we obtained satisfied surgical result.

关 键 词：颈椎 脊柱后凸 脊柱融合术 病例报告 

分 类 号：R687.3[医药卫生—骨科学]