摘要
目的探讨避免手术并发症评价单纯后路切除胸腰段半椎体治疗青少年先天性脊柱侧后凸畸形的安全性和有效性。方法单纯后路胸腰段半脊椎切除治疗28例青少年先天性脊柱侧后凸畸形。其中12例半脊椎位于T12,10例半脊椎位于L1,6例半脊椎位于T11。Cobb角测量后凸角度平均75°,侧凸角度平均48℃。病人平均年龄14岁,其中男性19例,女性9例。所有病例均采用单纯后路半脊椎切除、椎弓根内固定系统矫形固定。分析本组资料术中操作的可行性、手术时间、出血量、术中术后并发症和畸形的矫正。结果平均手术时间3．7 h,失血量平均900 ml。2例术中出现血气胸,其中1例经伤口引流愈合,另1例术后置胸腔管引流1周愈合。1例病人术中出现脑脊液漏,术后自然愈合。1例术后出现一过性单侧肋间神经痛,未经任何治疗1周后消失;并发症发生率为14％。所有病例未出现早期或晚期脊髓损伤症状和伤口感染。平均随访3．5年,所有病例均获得骨性融合。在最后随访时,Cobb角测量后凸角度平均19°,侧凸角度平均14°,所有病例躯干平衡。结论单纯后路切除胸腰段半脊椎治疗先天性脊柱侧后凸畸形操作性强,同前后路联合手术比较,缩短了手术时间,明显减轻了手术创伤,矫形效果好,无严重神经损伤或其他严重并发症。
Objective To investigate the safety and efficacy of resection of hemivertebrae by posterior approach in treatment of thoracolumnbar kyphoscoliosis in adolescents. Methods twenty-eight patients of kyphoscoliosis, 19 male and 9 female, aged 12 ～ 16, 12 cases with the hemivertebra located in T12, 10 cases in L1, and 6 cases in Tn , and with a mean angle of 75° in kyphosis and 48° in scoliosis by the Cobb measurement, underwent resection of the hemivertebrae via the posterior approach and were followed up for 3.5 years. Results The mean surgical time was 3.7 hours and the average blood loss was 900 mL Intercostal neuralgia occurred in one patient and relieved automatically without treatment. Hemothorax and pneumothorax were found in two cases during the operation and were healed after 1 week. Solid fusion was obtained in all the patients. The Cobb measurement was 19° in kyphosis and 14° in scoliosis on average at the final follow-up. No neurological deficit and infection was noted in the late stage. Clinically, no spinal imbalance or trunk shift was observed in all patients. Conclusion Resection of hemivertebrae via posterior approach is safe and effective in the treatment of thoracolumnbar kyphoscoliosis in adolescents.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2006年第27期1881-1884,共4页
National Medical Journal of China
关键词
脊柱疾病
骨科外科手术
青少年
Spine diseases
Orthopedic procedures
Adolescent
