后路半椎体切除短节段固定儿童先天性脊柱畸形  

Posterior hemivertebrae resection and short-segment instrumented fusion for congenital spinal malformation in children

作　　者：张福勇[1] 王晓东[1] 甄允方[1] 方建峰[1] 祝振华 俞文涛 刘文栋 ZHANG Fu-yong;WANG Xiao-dong;ZHEN Yun-fang;FANG Jian-feng;ZHU Zhen-hua;YU Wen-tao;LIU Wen-dong(Department of Orthopaedics,Children's Hospital,Soochow University,Suzhou215000,China)

机构地区：[1]苏州大学附属儿童医院骨科,江苏苏州215000

出　　处：《中国矫形外科杂志》2024年第7期650-653,共4页Orthopedic Journal of China

基　　金：苏州市科技管理资助项目(编号:SYS2020155)。

摘　　要：[目的]探讨后路半椎体切除短节段固定治疗儿童先天性脊柱畸形的临床疗效。[方法]回顾性分析2016年12月—2020年6月采用后路半椎体切除短节段固定治疗的21例先天性半椎体畸形患儿的临床资料,评估临床及影像资料。[结果]所有患者均顺利完成手术,术中无神经血管损伤等严重并发症。手术时间平均(199.3±10.7)min;术中出血量平均(491.4±74.1)ml。手术固定融合节段平均(2.8±0.2)节。影像方面,与术前相比,术后即刻及末次随访时,冠状面Cobb角[(37.7±2.2)°,(10.7±2.0)°,(10.1±2.0)°,P<0.001]、局部侧凸Cobb角[(32.8±2.0)°,(7.2±1.8)°,(6.1±1.6)°,P<0.001]、顶椎偏移[(22.4±2.8)mm,(11.3±1.5)mm,(7.2±0.9)mm,P<0.001]、头侧代偿[(15.9±1.9)°,(6.2±1.1)°,(4.7±0.8)°,P=0.002]、尾侧代偿[(18.6±1.8)°,(7.8±1.3)°,(5.7±1.1)°,P<0.001]、局部后凸角[(19.0±3.0)°,(7.9±1.4)°,(7.3±1.4)°,P<0.001]均显著减小。[结论]单一后路超声骨刀切除半椎体,短节段固定儿童先天性脊柱侧凸畸形,手术时间短,术中出血少,矫形满意,临床效果好。[Objective]To investigate the clinical effect of posterior hemivertebrae resection and short segment instrumented fusion for congenital spinal malformations in children.[Methods]A retrospective study was conducted on 21 children who received posterior hemiver⁃tebra resection and short segment instrumented fusion for congenital hemivertebra malformation from December 2016 to June 2020.The clin⁃ical and imaging data were evaluated.[Results]All the patients had operation performed successfully with no serious complications such as neurovascular injury,while with operation time of(199.3±10.7)min,intraoperative blood loss of(491.4±74.1)ml and fusion segments of(2.8±0.2).Regarding imaging,compared with those preoperatively,the coronal Cobb angle[(37.7±2.2)°,(10.7±2.0)°,(10.1±2.0)°,P<0.001],local scoliotic Cobb angle[(32.8±2.0)°,(7.2±1.8)°,(6.1±1.6)°,P<0.001],top vertebrae migration[(22.4±2.8)mm,(11.3±1.5)mm,(7.2±0.9)mm,P<0.001],cephalad contralateral compensatory[(15.9±1.9)°,(6.2±1.1)°,(4.7±0.8)°,P=0.002],caudal compensatory[(18.6±1.8)°,(7.8±1.3)°,(5.7±1.1)°,P<0.001],and local kyphotic angle[(19.0±3.0)°,(7.9±1.4)°,(7.3±1.4)°,P<0.001]significantly reduced immediately post⁃operatively and at the latest follow-up.[Conclusion]Single posterior hemivertebra resection and short-segment instrumented fusion for congenital scoliosis deformity in children have advantages of short operation time,less intraoperative bleeding,satisfactory correction,do achieve good clinical consequences.

关 键 词：先天性畸形 脊柱侧凸 半椎体切除 脊柱融合 

分 类 号：R682.3[医药卫生—骨科学]