马凡氏综合征患者脊柱侧凸的矫治  

Surgical correction for scoliosis in Marfan syndrome

作　　者：李明[1] 杨洪平[2] 倪春鸿[1] 朱晓东[1] 刘洋[1] 白玉树[1] 赵新刚[1] 侯铁胜[1] 

机构地区：[1]第二军医大学附属长海医院骨科,上海市200433 [2]湖北省十堰市人民医院骨科,442000

出　　处：《中国脊柱脊髓杂志》2004年第4期229-232,共4页Chinese Journal of Spine and Spinal Cord

基　　金：国家自然科学基金(30271440);上海市科技启明星跟踪计划基金(2002QB1403)

摘　　要：目的:探讨马凡氏综合征(Marfan syndrome,MFS)患者脊柱侧凸的手术疗效.方法:对1997年9月至20024年 1月使用脊柱三维矫形内固定系统后路手术治疗的8例MFS患者脊柱侧凸的矫正度、脊柱平衡及并发症等进行分析.结果:8例患者随访12～48个月,平均24个月.6例KingⅡ型患者胸弯及腰弯的矫正率分别为47%、57%,随访矫正率丢失分别为21%和16%;1例King Ⅰ型患者胸弯及腰弯矫正率分别为25%及42%,随访矫正率丢失分别为21%和15%;1例KingⅢ型患者胸弯及腰弯的矫正率分别为58%、29%,随访矫正率丢失分别为9%和18%.所有患者躯干平衡得到改善,无神经并发症发生.2例出现交界性腰椎后凸,1例切口延迟愈合.结论:使用脊柱三维矫形内固定系统后路手术治疗马凡氏综合征患者脊柱侧凸可以获得满意疗效.Objective:To determine the surgical results of scoliosis in Marfan syndrome(MFS)and review its literature.Method:Eight Patients with scoliosis in MFS who underwent posterior operations with three-dimen-sional spinal instrumentation from September1997to January2002were evaluated for curve correction,spinal balance,and surgical complications.Result:For6patients with KingⅡtype,thoracic or lumbar curve correc-tion averaged47%?57%and loss of correction at follow-up was21%?16%,respectively.Thoracic or lumbar curve correction of1patient with KingⅠtype was25%?42%,but loss of correction at follow-up was21%?15%,respectively.In1patient with King type,thoracic or lumbar curve correction averaged58%?29%and loss of correction at follow-up was9%?18%,respectively.Trunk balance improved after surgery in all patients.No neurologic complications occurred.Junctional lumbar kyphoses developed in2patients.One incision union de-layed.Conclusion:Satisfactory results could be obtained to treat scoliosis in Marfan syndrome with three-dimen-sional instrumentations.

关 键 词：马凡氏综合征 脊柱侧凸 矫治 手术治疗 内固定 结缔组织疾病 

分 类 号：R682.3[医药卫生—骨科学] R593.2[医药卫生—外科学]