中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2013年
48期
8443-8448
,共6页
王晓平%陆明%马华松%周建伟%袁伟%牛晶%崔凯%陈阳%黄子瑞%秦柳花%郑蕊%张敬
王曉平%陸明%馬華鬆%週建偉%袁偉%牛晶%崔凱%陳暘%黃子瑞%秦柳花%鄭蕊%張敬
왕효평%륙명%마화송%주건위%원위%우정%최개%진양%황자서%진류화%정예%장경
骨关节植入物%骨与关节临床实践%先天性脊柱侧弯%半椎体%SPO截骨%椎弓根螺钉内固定系统%矢状位失平衡
骨關節植入物%骨與關節臨床實踐%先天性脊柱側彎%半椎體%SPO截骨%椎弓根螺釘內固定繫統%矢狀位失平衡
골관절식입물%골여관절림상실천%선천성척주측만%반추체%SPO절골%추궁근라정내고정계통%시상위실평형
背景：由半椎体形成的先天性脊柱侧弯在临床治疗上一直较为复杂。<br> 目的：寻找治疗半椎体以及半椎体合并极重度先天性脊柱侧弯的最佳方法。<br> 方法：选择2010至2012年间在解放军306医院骨科进行手术治疗的半椎体畸形患者共142例，手术治疗的方法主要为单纯半椎体切除植骨融合内固定，重度脊柱侧弯顶椎截骨脊柱短缩矫形内固定，一期后路胸腰椎截骨矫形，椎管减压矫形内固定手术。<br> 结果与结论：治疗后侧凸平均矫正率为70.9%，后凸平均矫正率为71.7%，随访14-35个月，平均23.4个月。末次随访时侧凸Cobb角丢失率为7.3%，后凸Cobb角丢失率为7.7%。随访X射线片证实植骨均融合，内固定物无松动、断裂，未发现失代偿现象。可见施行后路一期截骨固定融合可以有效地矫正半椎体畸形所致的脊柱侧后凸畸形，获得满意的脊柱矢状位、冠状位的平衡。
揹景：由半椎體形成的先天性脊柱側彎在臨床治療上一直較為複雜。<br> 目的：尋找治療半椎體以及半椎體閤併極重度先天性脊柱側彎的最佳方法。<br> 方法：選擇2010至2012年間在解放軍306醫院骨科進行手術治療的半椎體畸形患者共142例，手術治療的方法主要為單純半椎體切除植骨融閤內固定，重度脊柱側彎頂椎截骨脊柱短縮矯形內固定，一期後路胸腰椎截骨矯形，椎管減壓矯形內固定手術。<br> 結果與結論：治療後側凸平均矯正率為70.9%，後凸平均矯正率為71.7%，隨訪14-35箇月，平均23.4箇月。末次隨訪時側凸Cobb角丟失率為7.3%，後凸Cobb角丟失率為7.7%。隨訪X射線片證實植骨均融閤，內固定物無鬆動、斷裂，未髮現失代償現象。可見施行後路一期截骨固定融閤可以有效地矯正半椎體畸形所緻的脊柱側後凸畸形，穫得滿意的脊柱矢狀位、冠狀位的平衡。
배경：유반추체형성적선천성척주측만재림상치료상일직교위복잡。<br> 목적：심조치료반추체이급반추체합병겁중도선천성척주측만적최가방법。<br> 방법：선택2010지2012년간재해방군306의원골과진행수술치료적반추체기형환자공142례，수술치료적방법주요위단순반추체절제식골융합내고정，중도척주측만정추절골척주단축교형내고정，일기후로흉요추절골교형，추관감압교형내고정수술。<br> 결과여결론：치료후측철평균교정솔위70.9%，후철평균교정솔위71.7%，수방14-35개월，평균23.4개월。말차수방시측철Cobb각주실솔위7.3%，후철Cobb각주실솔위7.7%。수방X사선편증실식골균융합，내고정물무송동、단렬，미발현실대상현상。가견시행후로일기절골고정융합가이유효지교정반추체기형소치적척주측후철기형，획득만의적척주시상위、관상위적평형。
BACKGROUND:Clinical treatment of hemivertebrae-induced congenital scoliosis is a complex medical problem. OBJECTIVE:To find the optimal treatment for hemivertebrae accompanied by congenital scoliosis. <br> METHODS:Total y 142 hemivertebrae patients who had received surgical treatment in the Department of Orthopedics, the 306 Hospital of Chinese PLA, China from 2010 to 2012 were enrol ed. The main surgical treatment was hemivertebrae resection and bone fusion with internal fixation, apical osteotomy for severe scoliosis and spinal shortening with internal fixation, one-stage posterior thoracolumbar osteotomy with internal fixation, spinal decompression with internal fixation. <br> RESULTS AND CONCLUSION:After treatment, the average correction rate was 70.9%for scoliosis and 71.7%for kyphosis. The fol ow-up period was 14-35 months, with an average of 23.4 months. By the end of the final fol ow-up, the loss rate for Cobb’s angle was 7.3%for scoliosis and 7.7%for kyphosis. Fol ow-up X-ray films showed bone fusion and internal fixation without loosening, fracture, and decompensation. Implementation of one-stage posterior thoracolumbar osteotomy with internal fixation can effectively correct hemivertebrae-induced kyphoscoliosis to obtain a satisfactory spinal sagittal and coronal balance.
