三维矫形手术治疗青少年特发性脊柱侧凸.pdfVIP

中国脊柱脊髓杂志2008年第l8卷第3期 Chinese Journal of5iPine and 5iPinal Cord，2008，Vo1．18，No．3 177 三维矫形手术治疗青少年特发性脊柱侧凸 陈建庭，翁科捷，金大地，张忠民，江建明，王吉兴，瞿东滨，鲁凯伍 (南方医科大学附属南方医院脊柱骨病科 510515广东省广州市) 【摘要】目的：回顾分析三维矫形内固定手术治疗青少年特发性脊柱侧凸(AIS)的临床效果。探讨手术相关融 合区的选择问题。方法：2001年一2006年在我院行三维矫形内固定手术的AIS患者78例，男27例，女51例， 年龄 1O～l8岁，平均 15．6岁，其中Lenke I型38例，Lenke II型6例，LenkeⅢ型 I1例．Lenke IV型1例， Lenke V型14例，Lenke VI型8例。术前冠状面Cobb角平均56o，顶椎偏距平均5．9cm。躯干偏移距离平均 2．8cm。根据患者畸形类型和柔韧性选择融合范围。术后及随访时在x线片上测量主弯冠状面的Cobb角、顶椎 偏距、躯干偏移距离。结果：术后随访 1～5年，平均28个月，冠状面Cobb角平均残留23o，矫正率为59％；终末 随访平均丢失4．5。，丢失率为8％；顶椎偏距平均残留2．7cm，矫正率为55％，终末随访时平均丢失0．5cm。丢失 率为8．5％；终末随访时躯干偏移距离平均 1．4cm。结论：三维矫形内固定手术能有效改善AIS畸形。根据畸形 特点选择正确的融合区进行适度的矫正是手术成功的关键。 【关键词】青少年特发性脊柱侧凸；三维矫形；融合区 中图分类号：R682．3，R687．3 文献标识码：A 文章编号：1004-406X(2008)一03—0177—05 correction surgery for the treatment of adolescent idiopathic scoliosis／CHEN Jiant- ing。WENG Kejie。J Dadi。et al／／Chinese Journal of Spine and Spinal Cord。2008。18(3 J：177-181 【Abstract】 Objective：A retrospective study was performed to evaluate the outcome of three-dimensional cor- rection for adolescent idiopathic scoliosis(AIS)and discuss the principle for selection of fusion area、Method： Seventy eight patients with AIS were classified and treated with three-dimensional correction surgery from 2001 to 2006．There were 27 male and 51 female with the average age of 15．6 years(range，10 to 18 years)． The cases were classified according to the Lenke surgical classification，including type I 38 cases，type II 6 cases，typeⅢ 11 cases，type IV 1 case，type V 14 cases，type VI 8 cases．The major curve Cobb angles，the distance of apical vertebra shift and trunk shift，were measured and analyzed in the preoperative，postoperative and final follow-up radiographies．Th e average preoperative coronal Cobb ansle Was 56。，the distance of both apical v