【摘要】 目的 探究头颅-骨盆牵引 (halo-pelvic traction，HPT) 在重度青少年脊柱畸形中冠状位、矢状位和轴位的矫形效果。方法 采用回顾性病例系列研究的方法，对 2019 年 9 月至 2022 年 9 月在我院行术前 HPT 的 32 例重度青少年脊柱畸形患者影像学资料进行分析，其中男 15 例，女 17 例，平均年龄 (13.15±1.42) 岁，平均牵引时间 (9.32±3.31) 周。对比牵引前和牵引结束时冠状位、矢状位和轴位的相关参数，尤其是上胸弯 (proximal thoracic，PT)、主胸弯 (main thoracic，MT)、胸腰弯 / 腰弯 (thoracolumbar / lumbar，TL / L)Cobb’s 角，胸椎后凸 (thoracic kyphosis，TK)、胸腰段后凸 (thoracolumbar kyphosis，TLK)、腰椎前凸 (lumbar lordosis，LL) 以及主胸弯顶椎旋转度 (apical vertebral rotation，AVR)，并记录相关并发症情况。结果 本组影像学冠状位参数和 TK 均有显著改善 (P < 0.001)，而主胸弯顶椎轴位旋转无显著变化 (AVR＿sac P=0.156，AVR＿AD P=0.705)。2 例出现单侧展神经麻痹，3 例出现手指麻木，随访时均有所改善。结论 术前 HPT 可以有效改善重度青少年脊柱畸形患者冠状位和矢状位畸形，但对轴位顶椎旋转畸形矫形效果较差。因此如需脊柱三维矫形，还需要辅助其它手术方法。更多还原

【Abstract】 Objective To explore the correction effect in coronal,sagittal and axial planes of Halo-Pelvic Traction for severe adolescent scoliosis.Methods A retrospective case-series of severe adolescent scoliosis patients treated with Halo-Pelvic Traction (HPT) before surgery in our hospital from September 2019 to September 2022 was performed.Based on radiographic analysis,the coronal,sagittal and axial parameters were compared before and after HPT.The parameters included Cobb angle of Proximal Thoracic (PT),Main Thoracic (MT),Thoracolumbar / Lumbar (TL / L),Apical Vertebral Translation (AVT),Thoracic Kyphosis (TK),Thoracolumbar Kyphosis (TLK),Lumbar Lordosis (LL) and Apical Vertebral Rotation (AVR).The complications were also recorded.Results A total of 32 cases (male 15,female 17) were included with an average age of (13.15±1.42) years,and an average traction time of (9.32±3.31) weeks.The coronal parameters and thoracic kyphosis were improved significantly (P < 0.001).There was no significant difference in AVR of the main thoracic curve (AVR＿sac P=0.156,AVR＿AD P=0.705).The complications included 2 cases of unilateral abducens palsy and 3 cases of finger numbness,and all relived during the follow-up.Conclusions The correction effect of HPT in coronal and sagittal planes for severe adolescent scoliosis is satisfactory,but with no correction effect for AVR in the axial plane.If necessary,additional derotation maneuver should be performed in the surgery to achieve 3D deformity correction.更多还原