CAJ | 학술논문

目的：探讨半椎体切除治疗先天性脊柱侧后凸畸形的临床效果及应用价值。方法选取该院2011年1月至2013年1月收治的30例先天性脊柱侧后凸合并半椎体畸形患者为研究对象。其中，单纯半椎体、无结构性弯曲患者12例，行后路半椎体切除、短节段椎弓根螺钉固定术；合并前凸、半椎体凸向腹侧患者3例，行前路半椎体切除合并植骨融合固定术；合并结构性代偿弯患者15例，行后路经椎弓根半椎体切除、长节段矫形代偿弯固定融合术。对所有患者手术治疗临床效果进行对比分析。结果后凸术后平均 Cobb 角、末次随访平均 Cobb 角分别为（8．6±3．14）°、（11．2±7．23）°，脊柱后凸最终矫形率为58．6％；侧凸术后平均侧凸 Cobb 角（12．8±5．47）°，末次随访平均（16．2±6．24）°，脊柱侧凸最终矫形率为66．5％。脊柱后凸、侧凸手术治疗后平均 Cobb 角明显小于术前，差异有统计学意义（P＜0．05），脊柱后凸、侧凸均明显好转，术后未出现明显并发症，患者较满意。结论半椎体切除治疗先天性脊柱侧后凸畸形效果显著，脊柱侧后凸矫形率高，值得临床上进一步研究。
목적：탐토반추체절제치료선천성척주측후철기형적림상효과급응용개치。방법선취해원2011년1월지2013년1월수치적30례선천성척주측후철합병반추체기형환자위연구대상。기중，단순반추체、무결구성만곡환자12례，행후로반추체절제、단절단추궁근라정고정술；합병전철、반추체철향복측환자3례，행전로반추체절제합병식골융합고정술；합병결구성대상만환자15례，행후로경추궁근반추체절제、장절단교형대상만고정융합술。대소유환자수술치료림상효과진행대비분석。결과후철술후평균 Cobb 각、말차수방평균 Cobb 각분별위（8．6±3．14）°、（11．2±7．23）°，척주후철최종교형솔위58．6％；측철술후평균측철 Cobb 각（12．8±5．47）°，말차수방평균（16．2±6．24）°，척주측철최종교형솔위66．5％。척주후철、측철수술치료후평균 Cobb 각명현소우술전，차이유통계학의의（P＜0．05），척주후철、측철균명현호전，술후미출현명현병발증，환자교만의。결론반추체절제치료선천성척주측후철기형효과현저，척주측후철교형솔고，치득림상상진일보연구。
Objective To explore the clinical efficacy and application value of hemivertebra resection for treating congenital ky‐phoscoliosis .Methods 30 cases of congenital kyphoscoliosis and hemivertebral deformity in our hospital from January 2011 to Jan‐uary 2013 were selected as the research subjects .Among them ,12 cases of simple vertebral and non‐structural bending were per‐formed the posterior hemivertebral resection and short segment pedicle screw fixation ;3 cases of complicating lordosis and hemiver‐tebral protruding to the ventral side were performed the anterior hemivertebral resection and bone graft fusion fixation ;15 cases of complicating structural compensatory curve were performed the posterior transpedicle hemivertebral resection and compensatory bend long segment fixation and fusion .The clinical effects of surgical treatment for all patients were performed the comparative a‐nalysis .Results The mean postoperative kyphosis Cobb angle and the average final follow‐up Cobb angle were (8 .6 ± 3 .14) °and (11 .2 ± 7 .23) °respectively .The ultimate orthopedic rate of kyphosis was 58 .6% ;the average postoperative Cobb angle and and the average final follow‐up Cobb angle of scoliosis were (12 .8 ± 5 .47)°and (16 .2 ± 6 .24)°respectively ,the final orthopedic rate of scoliosis was 66 .5% .The mean Cobb angle of kyphosis and scoliosis after operation was significantly less than that before opera‐tion ,the difference was statistically significant(P< 0 .05) .Kyphosis and scoliosis were significantly improved .No significant post‐operative complications occurred .The effects were satisfied by the patients .Conclusion The hemivertebral resection has significant effect for treating congenital kyphoscoliosis with high kyphoscoliosis orthopedic rate and is worthy of further clinical study .