先天性半椎体畸形的手术治疗  

Surgical treatment of congenital hemivertebrae deformation

作　　者：马梦昆[1] 劳汉昌[1] 李伟强[1] 

机构地区：[1]云南省昆明医学院第二附属医院骨科,650101

出　　处：《中华小儿外科杂志》2002年第6期531-533,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的　探讨先天性半椎体手术治疗中的有关问题。方法　本组术前平均年龄 5 .4岁 ,单一半椎体 5例 ,多发半椎体 6例 ,共 18个半椎体全部行手术切除 ,其中 8例同期后路植骨融合 ,3例多发半椎体分两期切除 ,同时行凹侧骨桥切断加后路椎板植骨融合。结果　术后用石膏背心矫形 ,侧凸有不同程度改善 ,测量Cobb’s角 10°～ 5 5° ,平均 2 9.8°(术前 30°～ 80° ,平均 5 0 .9°) ,矫正率达 4 1.3%。9例获随访 ,平均随访时间 2 5个月 ,Cobb’s角 37.6°,丧失矫正 7.8°。结论　早期彻底切除半椎体及其他骨性僵硬因素可使生长中的脊柱逐渐获得平衡。对严重病例 。Objective To discuss related problems encountered in hemivertebral excisions. Methods Eighteen hemivertebrae (5 single and 6 multiple segments) in 11 patients with congenital scoliosis (mean age 5.4 years) were excised. 8 patients had one stage anterior hemivertebral body excision with posterior fusions. 3 patients had hemivertebrae removed at two levels by two stage procedures with the unilateral bar excisions and lamina fusions. Results Postoperatively, all patients were managed with a body cast. The deformity curvature decreased from 50.9° (range: 30 to 80°) preoperatively to 29.8° (range: 10 to 55°) postoperatively. The mean improvement was 41.3% . Nine patients were followed up for a mean of 25 months. The Cobbs' angle was 37.6° with a 7.8° loss of correction. Conclusions The key to optimal treatment is early removal of hemivertebrae and the other all coexisting rigid osseous anomalies to balance and align the developing spine. It is dangerous to attempt to yield the greater correction in a severe curve.

关 键 词：脊柱侧凸 儿童 手术方法 先天性半椎体畸形 手术治疗 

分 类 号：R726.8[医药卫生—儿科]