CAJ | 학술논문

目的探讨一期前后路半椎体切除节段性内固定治疗小儿先天性脊柱侧凸的可行性及疗效.方法回顾性分析35例半椎体所致的先天性脊柱侧凸,所有病例均施行了一期前后路半椎体切除节段性内固定术,并且获得1.2～8.7年的随访(平均5.3年),主要比较患儿手术前后Cobb's角的变化.结果术前脊柱侧凸Cobb's角为(42.5±6.7)°,术后纠正到(16.2±3.2)°,平均纠正率64.7%.14例明显后凸的Cobb's角由(33.5±5.2)°纠正到(13.3±5.6)°,平均纠正率53.2%.手术时间210～280 min,平均240 min.术中出血量80～200 ml,平均120 ml.最后随访时侧凸和后凸分别为(15.6±5.8)°和(14.2±3.3)°,与术后相比,无纠正丢失.无死亡和神经系统并发症.未发现内固定松动及断裂现象.结论一期前后路半椎体切除节段性内固定是治疗小儿先天性脊柱侧凸的有效术式,能够通过较短节段的融合获得满意的矫正.
목적 탐토일기전후로반추체절제절단성내고정치료소인선천성척주측철적가행성급료효.방법 회고성분석35례반추체소치적선천성척주측철,소유병례균시행료일기전후로반추체절제절단성내고정술,병차획득1.2～8.7년적수방(평균5.3년),주요비교환인수술전후Cobb's각적변화.결과 술전척주측철Cobb's각위(42.5±6.7)°,술후규정도(16.2±3.2)°,평균규정솔64.7%.14례명현후철적Cobb's각유(33.5±5.2)°규정도(13.3±5.6)°,평균규정솔53.2%.수술시간210～280 min,평균240 min.술중출혈량80～200 ml,평균120 ml.최후수방시측철화후철분별위(15.6±5.8)°화(14.2±3.3)°,여술후상비,무규정주실.무사망화신경계통병발증.미발현내고정송동급단렬현상.결론 일기전후로반추체절제절단성내고정시치료소인선천성척주측철적유효술식,능구통과교단절단적융합획득만의적교정.
Objective To discuss the feasibility and efficacy of one-stage anteroposterior hemivertebra resection and segmental internal fixation for young children with congenital scoliosis. Methods Thirty-five patients undergoing one-stage anteroposterior hemi-vertebra resection and segmental internal fixation were retrospectively studied. The mean followed-up period was 5.3 years ( range: 1.2 - 8.7). The Cobb's angle of scoliosis at pre and post-operation was compared. Results All children's parents were satisfied with the outcome. The Cobb' s angle of scoliosis was corrected from (42.5 ± 6.7 )° to ( 16.2 ±3.2)° at post-operation. The coronal correction rate was 64.7%. The angle of kyphosis improved from preoperative(33.5 ± 5.2)° to postoperative ( 13.3 ± 5.6)° in 14 cases. Operative duration was 210 - 280 minutes with an average of 240 minutes. The intra-operative blood loss was 80 -200 ml with an average of 120 ml. There was no significant correction loss at follow-up. No neurological complication, infection or pedicular fracture was reported. Conclusion The procedure of one-stage anteroposterior hemi-vertebra resection and segmental internal fixation is a safe and effective treatment for scoliosis by congenital hemivertebra in young children. A satisfactory correction may be achieved with a short fusion segment.