后路截骨矫正陈旧性胸腰椎骨折后凸畸形  

Posterior osteotomy for the correction of kyphosis secondary to old thoracolumbar fractures

作　　者：丁江平 郑国权[2] 唐国柱 王斌 张振云 李志斌 牛犇 DING Jiang-ping;ZHENG Guo-quan;TANG Guo-zhu;WANG Bin;ZHANG Zhen-yun;LI Zhi-bin;NIU Ben(Department of Spinal Surgery,Xinjiang Bazhou People's Hospital,Bazhou 841000,China;Department of Spine Surgery,General Hospital of CPLA,Beijing 100039,China)

机构地区：[1]新疆巴州人民医院脊柱外科,新疆巴州841000 [2]解放军总医院脊柱外科,北京100039

出　　处：《中国矫形外科杂志》2022年第22期2097-2099,2103,共4页Orthopedic Journal of China

摘　　要：[目的]探讨后路截骨矫治陈旧性胸腰椎骨折后凸畸形临床疗效。[方法]2006年9月—2019年6月,分别采用SPO、PSO、BDBO和PVCR截骨矫治陈旧性胸腰椎骨折后凸畸形41例成人患者,男32例,女9例,平均年龄(42.72±12.22)岁。评价临床与影像结果。[结果]所有患者均顺利完成手术,手术时间平均(4.20±1.34)h;术中出血量平均(1800.25±240.50)ml。随访时间(36.72±7.38)个月,与术前相比,术后12个月和末次随访VAS和0DI评分显著减少(P<0.05),而身高显著增加(P<0.05),ASIA脊髓功能分级显著改善(P<0.05)。影像方面,术后Cobb角、SVA和顶椎椎管矢状径较术前显著改善(P<0.05),后凸畸形矫正率78.56%,所有患者均达至骨性愈合。[结论]后路截骨矫治胸腰椎陈旧性骨折后凸畸形可获良好疗效。[Objective]To investigate the clinical outcomes of posterior osteotomy for old thoracolumbar fracture kyphosis.[Methods]From September 2006 to June 2019,41 adult patients,including 32 males and 9 female aged(42.72±12.22)years,underwent posterior osteotomy,involving SPO,PSO,BDBO and PVCR for kyphotic deformity secondary to old thoracolumbar fractures in our hospitals.The clinical and imaging consequences were evaluated.[Results]All patients had surgical procedures completed successfully,with operation time of(4.20±1.34)hours and intraoperative blood loss of(1800.25±240.50)ml.At 12 months postoperatively and the latest follow-up lasted for(36.72±7.38)months on average,the VAS and ODI scores significantly decreased(P<0.05),while body heights significantly increased(P<0.05),and ASIA grade for neurological function grade significantly improved compared with those preoperatively(P<0.05).In terms of imaging,the postoperative local kyphotic Cobb angle,SVA and sagittal diameter of the parietal vertebral canal significantly improved compared with those before surgery(P<0.05),with the kyphotic correction rate of 78.56%,and bone healing in all patients.[Conclusion]Posterior osteotomy does effectively correct the kyphotic deformity due to old thoracolumbar fracture in this study.

关 键 词：陈旧性胸腰椎骨折 后凸畸形 脊柱截骨术 矫形 

分 类 号：R683.2[医药卫生—骨科学]