摘要
目的评价一期经后路半椎体切除及多棒分段矫形治疗单个半椎体引起的中、重度僵硬性脊柱侧后凸畸形的初期手术效果。方技17例中、重度僵硬性先天性脊柱侧后凸畸形患者均经一期后路半椎体切除及多棒分段矫形内固定治疗，其中T102例，T104例，T125例，L13例，L23例；术前侧凸Cobb角为（67．9±8．2）°．后凸Cobb角为（73．0±10．6）°。结果所有患者安全完成手术，无死亡及神经损伤并发症发生。手术时间4．0～7．5h，平均5．6h；术中出血量500～3000mL，平均1050mL。1例术中切除肋骨小头时引起胸膜撕裂，发生血气胸，行胸腔闭式引流，1周后痊愈；随访时间12～35个月，平均19．4个月。随访x线片证实植骨均融合，未发现内固定物松动断裂、假关节形成等并发症。术后l周和末次随访时侧凸及后凸Cobb角与术前比较均明显改善，差异有统计学意义（P〈0．05）。结论一期经后路半椎体切除及多棒分段矫治单个半椎体引起的中、重度僵硬性先天性脊柱侧后凸畸形，方法有效且可行，在矫正脊柱侧弯的同时有效矫正脊柱后凸畸形。
Objective To evaluate the early clinical outcome of one-stage posterior hemivertebral resection and segmental multi-rod instrumentation for the treatment of medium-to-severe rigidity congenital kyphoscoliosis caused by a single hemivertebrae. Methods Seventeen patients with medium-to-severe rigidity congenital kyphoscoliosis were surgically treated by the posterior hemivertebral resection and segmental multi-rod instrumentation. Hemivertebrae were sited in Ti0 （9. cases）, T11（4 cases）, T12 （5 cases）, L1 （3 cases）, and L2 （3 cases）. The preoperative scoliotic Cobb angles were （67.9 4±8.2）° and kyphotic Cobb angles were （73.0 ±0.6）°. Results All patients underwent surgeries safely and there were no death or neurological injuries occurred. The operation time was 4.0 -7. 5 h （ averaged 5.6 h） and the perioperative bleeding was 500 -3 000 mL （averaged 1 050 mL）. One patient suffered from left pleura tearing during capitulum costae resection and incurred hemopneumothorax. The patient was treated by chest cavity closed drainage and recovered completely after one week. All cases were followed up for 12 -35 months （averaged 19.4 months）. Bony fusion was achieved in all patients and no pseudoarthrosis and implant failure was observed. The Cobb angles of scoliosis and kyphosis after one week of operations and at the time of the last follow-up were much better than those before the operations. The differences were statistically significant （P〈0. 05）. Conclusion The one-stage posterior hemivertebral resection and segmental multi-rod instrumentation is feasible and effectivein correcting scoliosis and kyphosis for the treatment of medium-to-severe rigidity congenital kyphoscoliosis caused by a single hemivertebrae.
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2014年第4期537-541,共5页
Journal of Shanghai Jiao tong University:Medical Science
关键词
先天性侧后凸
后路半椎体切除
僵硬
congenital kyphoscoliosis
posterior hemivertebra resection
rigid
