摘要
目的探讨低龄先天性脊柱侧弯手术治疗方法。方法低龄先天性脊柱侧弯患儿27例,依据手术方法分为2组,观察组14例行经后路半椎体切除手术,对照组13例行经后路半椎体切除+椎弓根螺钉内固定术,比较2组手术时间、术中出血量以及手术前、后冠状位主弯Cobb角和术后侧弯矫正情况。结果 (1)观察组手术时间[(173.86±50.06)min]、术中出血量[(76.14±28.61)mL]低于对照组[(262.69±48.30)min、(382.14±27.63)mL],2组比较差异有统计学意义(P<0.05);(2)观察组术前冠状位主弯Cobb角[(36.74±9.08)°]与对照组[(39.37±7.63)°]比较差异无统计学意义(P>0.05),2组术后冠状位主弯Cobb角[(20.37±3.61)°、(15.48±3.07)°]均较术前降低(P<0.05);观察组末次随访时冠状位主弯相应矫正率[(39.04±13.8)%]低于对照组[(51.68±11.82)%](P<0.05)。结论对合并脊髓畸形、需早期手术的低龄先天性脊柱侧弯患儿,单纯半椎体切除手术创伤小,是一种可行的治疗方法;但后路半椎体切除+椎弓根螺钉内固定对矫正和控制先天性脊柱侧弯畸形效果更好。
Objective To study the surgical treatment of congenital scoliosis in low-age children. Methods Twenty- seven low-age children with congenital scoliosis were divided into observation group （n= 14） and control group （n= 13）. Observation group underwent posterior hemvertebra resection, and control group underwent posterior hemvertebra resection ＋ pediele screw internal fixation. Results The mean operation lasting time was shorter and blood loss volume was significantly lower （173. 86±50.06） min, （76. 144± 28.61） mL） in observation group than those in control group （（262. 69±48.30） min, （382. 14±27. 63） mL） （P〈0. 05）. There was no significant difference in preoperative Cobb angle at coronal view between observation group （（36.74±9.08）°） and control group （（39.37 ±4. 7.63）°） （P〉0. 05）. The Cobb angles at coronal view in two groups after operation （（20. 37±3. 61）°, （15.48±3.07）°） were significantly smaller than those those before operation （P〈0.05）. The final follow-up showed the correction rate in the main curve was （39. 04± 13.8）% in observation group, significantly lower than that in control group （（51. 68±11.82）%） （P〈 0.05）. Conclusion For the low-age children with spinal cord malformation and congenital scoliosis, pure hemvertebra resection is a feasible treatment method with little trauma, but posterior hemvertebra resection＋ internal fixation is more effective for correction and control congenital scoliosis.
出处
《中华实用诊断与治疗杂志》
2015年第8期788-790,共3页
Journal of Chinese Practical Diagnosis and Therapy
关键词
先天性脊柱侧弯
半椎体
疗效
低龄
Congenital scoliosis
hemivertebra, therapeutic effect
low age
