摘要
[目的]探讨后路楔形截骨联合选择性钉棒矫形内固定治疗先天性僵硬性脊柱侧弯的临床疗效。[方法]选择本院2012年6月~2015年7月收治的15例青少年先天性僵硬性脊柱侧弯患者为对象,采用后路楔形截骨联合选择性钉棒矫形内固定术治疗,记录手术时间、出血量、住院费用、Cobb角矫正程度等指标。[结果]所有患者均顺利手术,无血管、神经、内脏损伤等严重并发症。手术时间(197.63±76.52)min,手术出血量平均(1271.32±167.39)ml,使用螺钉4~9枚,平均(6.12±2.14)枚;住院总花费平均(42783.92±5679.37)元。15例患者出院后均获得良好的随访,随访时间24~60个月,平均(21.31±6.72)个月,末次随访时,躯干偏移(4.31±1.97)mm,较术前显著减少,差异有统计学意义(P<0.05);X线片检查脊柱侧弯Cobb角(22.39±5.14°)和后凸Cobb角(26.32±5.15°)均较术前显著减少,差异具有统计学意义(P<0.05)。[结论]后路楔形截骨联合选择性钉棒矫形内固定治疗先天性僵硬性脊柱侧弯经济、安全,临床效果满意。
[Objective]To investigate the clinical outcomes of posterior wedge osteotomy combined with selected pedicle screw-rod fixation for correction and instrumented fusion for rigid congenital scoliosis.[Methods]From June 2012 to July 2015,a total of 15 patients with rigid congenital scoliosis received posterior wedge osteotomy combined selected pedicle screwrod fixation for correction and instrumented fusion in our department.The operation time,intraoperative blood loss,hospitalization expenses,correction extent in term of Cobb angle were recorded.[Results]All the patients had surgical procedures performed smoothly without serious complications,such as neurovascular injuries.The operation lasted for(197.63±76.52)min on average,associated with intraoperative blood loss of(1 271.32±167.39)ml,4~9 pedicle screws placed and(42 783.92±5 679.37)Yuan paid for hospitalization.The 15 patients were followed up for 2 to 5 years.At the latest follow up the trunk deviation significantly decreased compared with that before operation(P<0.05).In term of radiographic measurement,both the Cobb angle of scoliosis and Cobb angle of kyphosis significantly decreased at the latest follow-up compared with those before operation(P<0.05).[Conclusion]This posterior wedge osteotomy combined with selected pedicle screw-rod fixation for correction and instrumented fusion is efficient,safe and reliable surgical procedure for rigid congenital scoliosis.
作者
韩耀光
潘富文
邓睿
云波
王启琪
孙军萍
HAN Yao-guang;PAN Fu-wen;DENG Rui;YUN Bo;WANG Qi-qi;SUN Jun-ping(Department of Orthopaedics,The Third People's Hospital of Hainan Province,Sanya 572000,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2019年第13期1159-1162,共4页
Orthopedic Journal of China
基金
2012年度海南省医学普通科研立项课题(编号:琼卫2012PT-38)
关键词
先天性僵硬性脊柱畸形
后路楔形截骨
选择性钉棒固定
矫形
融合固定术
rigid congenital spinal deformity
posterior wedge osteotomy
selected pedicle screw-rod fixation
correction
instrumented fusion
