先天性颈椎侧凸畸形的外科治疗及研究进展  

Surgical treatment and research progress of congenital cervical scoliosis

作　　者：曹硕 孙宇[1,2,3] 周非非[1,2,3] 李危石 CAO Shuo;SUN Yu;ZHOU Feifei;LI Weishi(Department of Orthopaedics,Peking University Third Hospital,Beijing 100191;Engineering Research Center of Bone and Joint Precision Medicine,Ministry of Education,Beijing 100191;Beijing Key Laboratory of Spinal Disease Research,Beijing 100191,China)

机构地区：[1]北京大学第三医院骨科,北京100191 [2]骨与关节精准医学教育部工程研究中心,北京100191 [3]脊柱疾病研究北京市重点实验室,北京100191

出　　处：《中华骨与关节外科杂志》2023年第7期653-661,共9页Chinese Journal of Bone and Joint Surgery

基　　金：首都临床特色应用研究与成果推广项目(Z161100000516004)。

摘　　要：先天性颈椎侧凸畸形是指由于颈椎椎骨先天性发育异常,出现冠状面失衡,导致颈椎侧凸畸形,外观上表现为头颈部向一侧歪斜,为一种罕见疾病。椎骨发育异常可分为形成障碍、分节障碍或两者同时出现,可以同时合并其他脊柱节段椎骨畸形或骨骼外畸形。手术治疗对于矫正严重颈椎侧凸畸形可以获得满意的效果。目前经典的手术方式为前后联合入路半椎骨切除术,侧凸矫正效果满意,但是手术难度大、风险高,术中需要在脊髓周围截骨、暴露神经根及椎动脉等操作。因此,一些学者设计了其他手术方式,力求在充分矫正颈椎侧凸的同时,避免上述高风险的手术步骤,降低手术难度。本文对目前矫正先天性颈椎侧凸畸形的外科治疗方式及临床疗效进行综述,以期为骨科医师治疗先天性颈椎侧凸畸形提供参考。Congenital cervical scoliosis is a rare disease of cervical spine,which is caused by the imbalance of cervical spine in coronal plane due to congenital abnormal development of cervical vertebrae.It is manifested as the head and neck skew to one side in appearance.Cervical vertebral deformity can be classified as formation failure,segmentation failure or both,and can be combined with vertebral malformations at other spinal segments or extraskeletal malformations.Surgical correction of severe cervical scoliosis can achieve satisfactory results.At present,the classic surgical method is hemivertebra resection through anterior and posterior combined approach,which can achieve satisfactory correction.However,the operation is difficult and risky for the requirement of osteotomy around the spinal cord,exposure of nerve root and vertebral artery during the procedure.In view of this,other surgical methods have been developed to avoid the above-mentioned high-risk surgical steps and reduce the difficulty of surgery.We reviewed surgical methods and clinical efficacy of congenital cervical scoliosis correction in order to provide helps in the treatment of this disease.

关 键 词：先天性颈椎侧凸畸形 成形障碍 分节障碍 脊柱融合术 半椎骨切除术 凹侧撑开术 

分 类 号：R687.3[医药卫生—骨科学]