贵州医科大学学报

2016, v.41;No.195(12) 1466-1469

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后路半椎体切除长节段固定矫治先天性脊柱畸形的临床疗效
Clinical Efficacy of Posterior Hemivertebra Resection Combined with Long Segment Fixation for Treating Congenital Spinal Deformity

陈东;杨华;周林;潘家曌;
CHEN Dong;YANG Hua;ZHOU Lin;PAN Jiazhao;Guizhou Medical University;

摘要(Abstract):

目的:评价后路一期半椎体切除、三柱松解、椎弓根钉棒系统矫形治疗中重度先天性脊柱畸形的临床疗效。方法:28例半椎体畸形患者,采用后路半椎体切除、三柱松解、椎弓根钉棒系统矫形治疗,观察患者手术时间及手术中出血量,术后1周,1、3、6月,1年及2年随访,比较术前、术后各随访时点站立位全脊柱正侧位X线片、冠状面和矢状面Cobb角,观察并发症。结果:手术时间5~10 h,平均7.5 h;术中出血量300~2 100 mL,平均970 mL;术后1周及末次随访时侧凸和后凸Cobb角与术前比较均有明显改善,差异有统计学意义(P<0.05);所有病例均获得骨性融合,无严重并发症发生。结论:后路一期半椎体切除、三柱松解、椎弓根钉棒系统矫形治疗中重度先天性脊柱畸形安全有效。
Objective:To evaluate the surgical outcomes of posterior hemivertebra resection and three column relaxation with transpedicular instrumentation in the treatment of medium-to-severe rigidity congenital kyphoscoliosis caused by hemivertebra.Methods:28 consecutive cases of congenital scoliosis treated by posterior hemivertebra resection and three column relaxation with transpedicular instrumentation were investigated retrospectively.The clinical effects of surgical treatment for all patients were performed in the comparative analysis.Results:The average operation time was 7.5 hours(ranging 5.0~10.0 hours),the average blood loss in the operation was 970 mL(ranging 300~2 100 mL).All the patients got fusion at the final follow-up.There was no pseudarthrosis and instrument breakage,differences were statistically significant(P<0.05).Conclusions:Posterior hemivertebra resection,three column relaxation and internal fixation is a safe and reasonable surgical option for medium-to-severe rigidity congenital kyphoscoliosis,achieved reliable fusion and satisfactory effect.

关键词(KeyWords): 脊柱;脊柱侧凸;脊柱后凸;外科手术;半椎体切除;先天畸形;并发症
spine;scoliosis;kyphosis;surgical procedures;operative;hemivertebra resection;congenital deformity;complication

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作者(Author): 陈东;杨华;周林;潘家曌;
CHEN Dong;YANG Hua;ZHOU Lin;PAN Jiazhao;Guizhou Medical University;

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DOI: 10.19367/j.cnki.1000-2707.2016.12.023

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