贵州医科大学学报

2015, v.40;No.183(12) 1402-1405

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后路半椎体切除短节段矫形植骨融合治疗儿童先天性脊柱畸形
The Clinical Observation of Infant Congenital Spinal Deformity Treatment by Posterior Hemivertebra Resection and Short Segment Correction

陈林;杨华;卢文;陈东;
CHEN Lin;YANG Hua;LU Wen;CHEN Dong;Department of Orthopedics,People's Hospital Of Jiangbei District;Department of Spinal Surgery,Affiliated Hospital of Guizhou Medical University;

摘要(Abstract):

目的:研究后路半椎体切除短节段矫形植骨融合治疗儿童先天性脊柱畸形(CVM)的疗效。方法:对12例CVM患儿采用后路半椎体切除、钉棒系统短节段矫形及植骨融合内固定术治疗,术后佩戴外支具>3月;比较术前术后主弯矢状面、主弯冠状面、头侧代偿及尾侧代偿Cobb角和顶椎偏移距离。结果:12例CVM患儿术后主弯冠状面Cobb角即刻矫正率81.7%,矢状面Cobb角即刻矫正率77.5%,头侧代偿弯Cobb角即刻矫正率69.4%,尾侧代偿弯Cobb角即刻矫正率72.0%,顶椎偏移矫正率65.5%,与术前比较差异有统计学意义(P<0.05);末次随访矫正率无明显丢失,与术后1月的影像学指标比较差异无统计学意义(P>0.05)。结论:后路半椎体切除椎弓根钉棒系统矫形内固定术治疗CVM患儿,可获得在冠状面及矢状面满意矫形效果,创伤小,并发症较少,是一种有效可靠的手术治疗方法。
Objective: To investigate the clinical effects of posterior hemivertebra resection and short segment correction with pedicle instrumentation in the surgical treatment of infant congenital vertebral malformations( CVM). Methods: Twelve children with CVM were performed with hemivertebra resection posteriorly,short segment correction and bone graft fusion fixation. Postoperative external support was attached for more than 3 months. Standing anteroposterior and lateral radiographs were compared at preoperative and postoperative stage and were reviewed to determine the coronal curve magnitude and sagittal alignment. Results: The immediate correction rate of the main bending coronal Cobb angle was 81. 7% with sagittal Cobb angle 77. 5%,compensatory head side Cobb angle 69. 4%,compensatory caudal curve Cobb angles 72. 0% and the correction rate of apical vertebral dislocation 65. 5%.Comparison between pre-operation and post-operation showed significant difference( P < 0. 05),but comparison between post-operation and the last follow-up showed no significant difference( P > 0. 05).Conclusion: Through posterior segmental pedicle screw instrumentation operation,the teratogens could be eliminated directly and the correction effect of coronal and sagittal plane is good. It is an effective and reliable surgical treatment and worthy of clinical promotion.

关键词(KeyWords): 畸形;脊柱侧凸;脊柱后凸;后路半椎体切除;短节段矫形
abnormalities;scoliosis;kyphosis;posterior hemivertebra resection;short segment correction

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作者(Author): 陈林;杨华;卢文;陈东;
CHEN Lin;YANG Hua;LU Wen;CHEN Dong;Department of Orthopedics,People's Hospital Of Jiangbei District;Department of Spinal Surgery,Affiliated Hospital of Guizhou Medical University;

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DOI: 10.19367/j.cnki.1000-2707.2015.12.032

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