后路半椎体切除短节段融合治疗先天性脊柱侧弯疗效观察.docVIP

后路半椎体切除短节段融合治疗先天性脊柱侧弯疗效观察 　　【摘要】 目的：探讨后路半椎体切除短节段融合治疗先天性脊柱侧弯的临床疗效。方法：选取30例本院收治的先天性脊柱侧弯患儿，经后方入路半椎体切除后，一期行短关节椎弓根螺钉矫形固定和脊柱植骨融合术，比较患儿手术前后及随访期内的脊柱侧弯情况及后凸Cobb’s角。结果：患儿脊柱畸形情况改善明显，冠状面半椎体节段侧弯Cobb’s角术前平均41.3°、术后平均15.3°，矫正率63.0%，末次随访平均14.8°，矫正率64.2%；冠状面全主弯Cobb’s角术前平均46.8°、术后平均18.6°，矫正率60.3%，末次随访平均17.6°，矫正率62.4%；矢状面半椎体节段术前平均后凸15.3°，术后Cobb’s角降至生理曲度正常范围，术后尾侧和头侧代偿弯也有明显改善，5项数据手术前后比较差异均有统计学意义（P0.05）。结论：后路半椎体切除短节段融合治疗先天性脊柱侧弯疗效显著，该术式能够达到矫正先天性脊柱侧弯的目的，在患儿骨骼成熟前治疗，可有效预防继发性脊柱病变，值得在临床上推广使用。 　　【关键词】 先天性脊柱侧弯； 脊柱融合术； 半椎体切除 　　Clinical Observation of Hemivertebra Resection Only Via Posterior Approach and Short-Segment Transpedicular Instrumentation for Congenital Scoliosis/LUO Jia-wei.//Medical Innovation of China，2015，12（15）：070-073 　　【Abstract】 Objective：To study the clinical observation of hemivertebra resection only via posterior approach and short-segment transpedicular instrumentation for congenital scoliosis.Method：30 cases with a single hemivertebra from 5 to 14 years old who underwent operative treatment were evaluated.Hemivertebra resection through posterior approach and short-segment transpedicular instrumentation were used for correction of the scoliosis and kyphosis deformities.Cobb’s angles of the segmental curve， total main curve， cranial and caudal compensatory curves and kyphosis were measured on the posteroanterior and lateral radiographs.Result：The patients in this study showed satisfied results.The mean Cobb’s angles of the segmental curve， total main curve， cranial and caudal compensatory curves and kyphosis were all statistically significant difference among before surgery， after surgery and the lastest follow-up assessment （P0.05）.Conclusion：Hemivertebra resection and short-segment transpedicular instrumentation could be performed only through posterior approach， which had exerted satisfiactory correction on congenital scoliosis.If the operation is performed before the maturity of the bone， it will effectively prevent the formation of secondly spinal deformities.It