【摘要】 目的观察后路半椎体切除并360°松解植骨融合内固定治疗半椎体所致先天性脊柱侧后凸畸形的临床效果。方法回顾性分析自2004年1月1日～2011年12月31日施行后路半椎体切除并360°松解植骨融合内固定术的24例先天性脊柱侧后凸患者的临床资料,术前侧凸Cobb角48.50°±10.32°(40°～82°),伴后凸畸形12例,后凸Cobb角27.20°±4.76°(13°～38°)。均行后路一期半椎体切除并360°松解植骨融合内固定术,术后1周及随访时复查全脊柱正侧位X线片,每3月随访1次。结果术后侧凸Cobb角为12.90°±5.64°(5°～18°),矫正率为73.4%;12例伴后凸畸形者后凸Cobb角为8.70°±3.12°(6°～15°),矫正率为68.1%;术后随访6～36月,平均14.6个月,末次随访侧凸Cobb角为16.30°±6.23(6°～22°),最终矫正率为66.4%,后凸Cobb角为11.30°±7.21(8°～21°),最终矫正率为58.5%;术后植骨融合部位骨痂形成良好,无感染、内固定器械断裂等并发症。结论后路一期半椎体切除并360°松解植骨融合内固定治疗先天性脊柱侧后凸可直接去除致畸因素并起到良好的矫形效果。更多还原

【Abstract】 Objective To evaluate the surgical effect of the procedure of posterior hemivertebra resection,360° relaxation and bone graft fusion and fixation for congenital kyphoscoliosis.Methods 20 patients with congenital kyphoscoliosis underwent posterior hemivertebra resection,360° relaxation and bone graft fusion and fixation from January 1,2004 through December 31,2011 in our institution were reviewed,which included 12 males and 8 females.The average age was 15.2 years(range,9~36).Location of the hemivertebra included 3 cases at thoracic spine,14 cases at lumbar spine and 3 cases at thoracolumbar spine.The average preoperation Cobb angle of scoliosis was 48.5°±10.32°(40°~82°) and 12 case were associated with kyphosis with the average Cobb angle 27.2°±4.76°(13°~38°).All the patients underwent one stage posterior hemivertebra resection,360° relaxation and bone graft fusion and fixation and correction with instrumentation.The X-ray film was reexamined at one week after operation and each follow-up.Patients were followed every 3 months after surgery.Results The average preoperation Cobb angle of scoliosis was 12.9°±5.64(5°~18°),the rate of correction was 73.4%.The average preoperation Cobb angle of kyphosis of 12 case was 8.7°±3.12°(6~15),the rate of correction was 68.1%.All the patients were followed up for 6~36 months with an average of 14.6 months,whose final follow-up average Cobb angle of scoliosis and rate of correction were 16.3°± 6.23(6°~22°) and 66.4% and average Cobb angle of kyphosis and rate of correction were11.3°± 7.21(8°~21°) and 58.5%.There were no complications,neural dysfunction,infection and fracture of internal instrument be found.Conclusion The hemivertebra resection,360°relaxation and bone graft fusion and fixation has a good capability of correcting congenital kyphoscoliosis caused by hemivertebra.更多还原