【摘要】 目的应用TexasScottishRiteHospital（TSRH）系统矫正脊柱侧凸的冠状面畸形、矢状面畸形和旋转畸形。方法1998年1月～1999年6月应用TSRH系统治疗脊柱侧凸32例，其中男6例，女26例；年龄11－45岁，平均16.4岁。特发性侧凸21例，先天性侧凸11例。术前冠状面畸形（Cobb法）为44°－125°，平均71.2°；矢状面后凸畸形（T2-12）为-16°～67°，平均49．2°；旋转畸形（Nash－Moe法）为Ⅰ～Ⅲ度。术前躯干移位3～9cm，平均4．8cm。结果术后所有病例经6～24个月，平均9．7个月随访。冠状面畸形为10°～73°，平均26．6°，平均矫正率为63．8％；矢状面后凸（T3－12）为10°～45°，平均28°；旋转畸形平均矫形1度。躯干移位为0．5－5．0cm，平均1．6cm，平均矫形66．7％。浅表感染及下钩滑脱各1例，发生率为3．1％。所有病例术中、术后均无脊髓神经损伤。结论TSRH系统具有三维矫形能力，不仅可矫正冠状面畸形，而且可矫正矢状面和旋转畸形，效果可靠、操作方便、并发症少。术后不需石膏固定。更多还原

【Abstract】 Objective To evaluate the results of TSRH instrumentation in the correction of frontal,sagittal and axial plane deformity of scoliosis. Methods From January 1998 to June 1999, thirty-two consecutive patients with scoliosis underwent anterior or posterior spinal instrumentation and fusion using TSRH instrumentation. There were 6 males and 26 females, with an average age at the time of surgery of 16. 4 years (range, 11- 45). Twenty-one cases were idiopathic scoliosis and 11 cases were congenital. The preoperative curve measurement showed an average of 71. 2° (range, 44° - 125°), and 49. 2° (range, - 16° - 67°) in frontal and sagittal respectively, while axial plane deformity (Nash - Moe) ranged from Ⅰ to Ⅲ degree. Preoperative trunk shift averaged 4. 8 cm (range, 3 - 9 cm). Results All the patients were followed-up for an average of 9. 7 months (range, 6 - 24 months) after operation. The averaged frontal curve measured 26. 6°(range, 10° - 73°), a 63. 8% curve correction. Sagittal contours were well maintained by this instrumentation, thoracic kyphosis measured an average of 28° (range, 10° - 45°). Rotation of the apical vertebrae improved by an average of 1 degree. Postoperative trunk shift averaged 1. 6 cm (range, 0. 5 - 5. 0 cm), a 66. 7% average correction. Two patients had complications: superficial infection of incision and lower hook dislocation developed in each respectively, which accounted for 3. 1 % of the total. No neurologic deficit and pseudoarthrosis occurred in this series. Conclusion TSRH instrumentation may provide the three-dimensional correction, not only for the frontal and rotatory correction, but also well maintained sagittal contour. Fusion occurs reliable because of the stiffness of the construct, which also may eliminate the need for postoperative immobilization with a plaster cast and a lower rate of complication.更多还原