中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2015年
15期
70-73
,共4页
先天性脊柱侧弯%脊柱融合术%半椎体切除
先天性脊柱側彎%脊柱融閤術%半椎體切除
선천성척주측만%척주융합술%반추체절제
Congenital scoliosis%Spinal fusion%Hemivertebra resection
目的：探讨后路半椎体切除短节段融合治疗先天性脊柱侧弯的临床疗效。方法：选取30例本院收治的先天性脊柱侧弯患儿，经后方入路半椎体切除后，一期行短关节椎弓根螺钉矫形固定和脊柱植骨融合术，比较患儿手术前后及随访期内的脊柱侧弯情况及后凸Cobb’s角。结果：患儿脊柱畸形情况改善明显，冠状面半椎体节段侧弯Cobb’s角术前平均41.3°、术后平均15.3°，矫正率63.0%，末次随访平均14.8°，矫正率64.2%；冠状面全主弯Cobb’s角术前平均46.8°、术后平均18.6°，矫正率60.3%，末次随访平均17.6°，矫正率62.4%；矢状面半椎体节段术前平均后凸15.3°，术后Cobb’s角降至生理曲度正常范围，术后尾侧和头侧代偿弯也有明显改善，5项数据手术前后比较差异均有统计学意义（P<0.05）。结论：后路半椎体切除短节段融合治疗先天性脊柱侧弯疗效显著，该术式能够达到矫正先天性脊柱侧弯的目的，在患儿骨骼成熟前治疗，可有效预防继发性脊柱病变，值得在临床上推广使用。
目的：探討後路半椎體切除短節段融閤治療先天性脊柱側彎的臨床療效。方法：選取30例本院收治的先天性脊柱側彎患兒，經後方入路半椎體切除後，一期行短關節椎弓根螺釘矯形固定和脊柱植骨融閤術，比較患兒手術前後及隨訪期內的脊柱側彎情況及後凸Cobb’s角。結果：患兒脊柱畸形情況改善明顯，冠狀麵半椎體節段側彎Cobb’s角術前平均41.3°、術後平均15.3°，矯正率63.0%，末次隨訪平均14.8°，矯正率64.2%；冠狀麵全主彎Cobb’s角術前平均46.8°、術後平均18.6°，矯正率60.3%，末次隨訪平均17.6°，矯正率62.4%；矢狀麵半椎體節段術前平均後凸15.3°，術後Cobb’s角降至生理麯度正常範圍，術後尾側和頭側代償彎也有明顯改善，5項數據手術前後比較差異均有統計學意義（P<0.05）。結論：後路半椎體切除短節段融閤治療先天性脊柱側彎療效顯著，該術式能夠達到矯正先天性脊柱側彎的目的，在患兒骨骼成熟前治療，可有效預防繼髮性脊柱病變，值得在臨床上推廣使用。
목적：탐토후로반추체절제단절단융합치료선천성척주측만적림상료효。방법：선취30례본원수치적선천성척주측만환인，경후방입로반추체절제후，일기행단관절추궁근라정교형고정화척주식골융합술，비교환인수술전후급수방기내적척주측만정황급후철Cobb’s각。결과：환인척주기형정황개선명현，관상면반추체절단측만Cobb’s각술전평균41.3°、술후평균15.3°，교정솔63.0%，말차수방평균14.8°，교정솔64.2%；관상면전주만Cobb’s각술전평균46.8°、술후평균18.6°，교정솔60.3%，말차수방평균17.6°，교정솔62.4%；시상면반추체절단술전평균후철15.3°，술후Cobb’s각강지생리곡도정상범위，술후미측화두측대상만야유명현개선，5항수거수술전후비교차이균유통계학의의（P<0.05）。결론：후로반추체절제단절단융합치료선천성척주측만료효현저，해술식능구체도교정선천성척주측만적목적，재환인골격성숙전치료，가유효예방계발성척주병변，치득재림상상추엄사용。
Objective:To study the clinical observation of hemivertebra resection only via posterior approach and short-segment transpedicular instrumentation for congenital scoliosis.Method:30 cases with a single hemivertebra from 5 to 14 years old who underwent operative treatment were evaluated.Hemivertebra resection through posterior approach and short-segment transpedicular instrumentation were used for correction of the scoliosis and kyphosis deformities. Cobb’s angles of the segmental curve, total main curve, cranial and caudal compensatory curves and kyphosis were measured on the posteroanterior and lateral radiographs.Result:The patients in this study showed satisfied results.The mean Cobb’s angles of the segmental curve, total main curve, cranial and caudal compensatory curves and kyphosis were all statistically significant difference among before surgery, after surgery and the lastest follow-up assessment (P<0.05). Conclusion:Hemivertebra resection and short-segment transpedicular instrumentation could be performed only through posterior approach, which had exerted satisfiactory correction on congenital scoliosis.If the operation is performed before the maturity of the bone, it will effectively prevent the formation of secondly spinal deformities.It was worthy of clinical application.
