后路半椎体切除器械矫正内固定治疗先天性脊柱侧凸_临床医学论文.docVIP

后路半椎体切除器械矫正内固定治疗先天性脊柱侧凸_临床医学论文 后路半椎体切除器械矫正内固定治疗先天性脊柱侧凸_临床医学论文 作者：詹世强，王义生，马元琛，柯雨洪，林秉涛 【摘要】 [目的]探讨后路半椎体切除、器械矫正内固定治疗先天性脊柱侧凸的临床疗效。[方法] 2002年7月～2006年12月，后路半椎体切除、器械矫正内固定治疗先天性脊柱侧凸39例，男22例，女17例;平均年龄8.3岁(3～15岁)。完全分节性半椎体30例，部分分节性半椎体9例。内固定器械包括ISOLA 16例、CD-Horizon 10例、MOSS-Miami 10例、TSRH 3例。术前后摄站立位全脊柱正侧位片，观察手术前后侧凸的矫正率及躯干平衡情况。[结果]术后随访1～4.5年，平均2.8年，术前冠状面Cobb’s角平均48°，术后13°，末次随访平均13.2°，平均矫正率70.2%。矢状面Cobb’s角术前平均39°，术后12.1°，末次随访12.7°，平均矫正率68.7%。所有患儿植骨融合牢固，躯干平衡良好。无神经系统并发症，无植入物折断及松动、无感染等并发症，1例出现曲轴现象。[结论]后路半椎体切除、器械矫正内固定对先天性脊柱侧凸是一种安全、有效的矫治方法。先天性脊柱侧凸应提倡早期手术矫治。 【关键词】 先天性脊柱侧凸; 半椎体畸形; 半椎体切除; 器械内固定 　　Abstract: [Objective]To evaluate the clinical results of posterior hemivertebra resection and correction with transpedicular instrumentation for congenital scoliosis. [Method]From July 2002 to December 2006, thirty-nine consecutive cases,including 22 males and 17 females, underwent posterior hemivertebra resection and correction using transpedicular instrumentation. The average age at surgery was 8.3 years ranging from 3 to 15 years. There were 30 cases with fully segmented hemivertebra and 9 cases with partial segmented hemivertebra. Instrument included 16 cases of ISOLA, 10 cases of CD-Horizon, 10 cases of Moss-Miami and 3 cases of TSRH. The pre- and post- operative standing radiographic and at final follow-up were measured, and the Cobb’s angles in the coronal and sagittal plane were analyzed, respectively.[Result]The average follow-up was 2.8 years ranging from 1 to 4.5 years. The Cobb’s angle in coronal plane was corrected from 48° to 13°postoperatively and 13.2° at final follow-up, representing 70.2% correction rate. The kyphosis was corrected from 39° to 12.1° postoperatively and 12.7° at final follow-up, representing 68.7% correction rate. All cases had bony fusion,there was no neurological complication, no implant failure or infection.One case had crankshaft phenomenon.[Conclusion]Posterior hemiveterbra resection with instrumentation is a safe and effective treatment option for congenit