微创式V型截骨分次矫正强直性脊柱后凸.docVIP

　　微创式V型截骨分次矫正强直性脊柱后凸 【摘要】 ［目的］用微创式V型截骨分次矫正强直性脊柱后凸的手术 方法 代替传统的手术方法，减轻了对病人的手术创伤，将复杂的大手术变为简单的微创手术，给病人减少了痛苦，节约了病人的经费开支。［方法］在局部浸润麻醉下，先用C型臂X线机选择截骨间隙，切口长6～8 cm，仅暴露1个椎板间隙，椎板V型截骨宽度8～10 mm，截骨完成后将手术床由反V型调成V型，截骨间隙将自动闭合复位，如不能自动闭合则轻轻按压帮助复位，一般复位均不成 问题 。将截骨时取下来的骨条作椎板后植骨。术毕应严格按照搬运规则将病人送回病房卧平床。术后2周内给予分次手法矫正和过伸位石膏背心固定。［结果］本组50例，除1例因过早自行拆除石膏背心造成畸形复发外，其余病例矫形效果满意，截骨部位骨性融合坚固。［结论］微创式截骨矫正术，损伤小、不用内固定减少病人的 经济 开支，V型截骨复位后互相嵌插稳定，用骨刀截骨间隙对合整齐，再加上椎板后植骨，过伸位石膏背心外固定，故均能在6个月后植骨融合坚固。 【关键词】 微创； V型截骨； 分次矫正； 强直性脊柱后凸 Minimally invasive V-shaped osteotomy for the correction of ankylosing spondylitis kyphosis//TIAN Hui-zhong,MA Yuan,LVXia.Department of Spinal Surgery,the 6th Affillated Hospital of Xinjiang Medical University,ethod］ The C-arm X-ray y,the length of incision and only exposed one interlaminal space,the inar V-shaped osteotomy m.The operating table reverse V to type after finished osteotomy,the space of osteotomy atica ly closed and replaced,if the space could not be automaticly closed,careful manipulation ass of osteotomy ina.Postoperation,stric and standardized regulation ed to send the patient back to anual correction and external fixation of hyperextended plaster vest ed respectivly 2 ore satisfied results except 1 case appeared recurrent deformity due to early removing of the plaster vest.［Conclusion］Minimal damage,loedical expenses(onstrated the minimally invasive V-shaped osteotomy is a very effective method.It has advantages of Mutual intercalated V-shaped osteotomy space and better stability after reduction,posterior bone graft of lamina and external fixation of hyperextended plaster vest,therefore,all patients can acquire the bone graft fusion afer 6 months. Key inimally invasive; V-shaped osteotomy; fractional correction; ankylosing kyphosis 本组在用传统方法手术 治疗 强直性脊柱炎后凸截骨术560例的基础上，从1995～2005年采用“微创式V型截骨分次矫正强直性脊柱后凸”的手术方法，该法主要用于后凸角小于80°Cobb’s角的轻度畸形患者，收到较好的治疗效果。微创式截骨术不用内固定器械，切口小，仅暴露截骨间隙，保留了周围的筋膜、韧带，肌肉组织不受损伤，术后反应小，伤口愈合快。术后分次手法矫正和石膏背心外固定，能保证良好的嵌插复位和植骨融合坚固。现将本组50例的治疗结果报告如下。 1 临床资料与方法 1.1