应用滑动椎弓根钉系统治疗青少年特发性脊柱侧凸畸形

Correct the Adolescent Idiopathic Scoliosis with Partial Sliding Pedicle Screw Systems

目的为了避免长节段融合后脊柱发生的生长停滞和曲轴现象,一种新设计的部分滑动椎弓根钉系统(PSPSS)通过短节段融合的方法用以治疗青少年特发性脊柱侧凸。方法方便选取2001年1月—2015年10月应用滑动椎弓根钉系统治疗生长发育期尤其是青少年特发性脊柱侧凸46例为研究对象,采用PSPSS系统治疗青少年特发性脊柱侧凸畸形。观察患者术前、术后和随访Cobb’s角、顶椎偏移量和顶椎旋转变化。结果通过后路切开矫形内固定,术后平均Cobb’s角28.26°。术后随访Cobb’s角26.74°。术后顶椎偏移2.12 cm,随访2.22 cm,术后和随访顶椎旋转0.62°。术后随访固定节段平均椎体生长1.0 mm。结论与传统三维固定方法相比,PSPSS系统不仅有相同的矫正率、相对较少的术后并发症,而且不限制术后脊柱的继续生长,避免了曲轴现象,是较好的治疗青少年特发性脊柱侧凸的内固定系统。

Objective To avoid “crankshaft” and developmental stagnation of the fusional spine. design a partial sliding pedicle screw systems with short segmental fusion to correct the adolescent idiopathic scoliosis. Methods Convenient select the January 2001 to October 2015 application of sliding pedicle nail treatment system growth and development especially in adolescent idiopathic scoliosis in 46 cases as the research object, the PSPSS system for the treatment of adolescent idiopath-ic scoliosis deformity. Preoperative, postoperative and follow up of s＇ Cobb ＇angle, the offset of the apical vertebra and the rotation of the top vertebral body were observed. Results The average Cobb’s angel, apical vertebrae deviation, and apical vertebrae rotation were 28.26°, 2.12 cm, 0.62 degree respectively after operation, with 26.74°, 2.22 cm and 0.62 ° at the latest follow up. The average height of vertebrae instrumented with sliding pedicle screws improved 1.0 mm at the follow up. Conclusion Compared with three dimensional instrumentations, PSPSS not only have the same correction ratio, less post-operative complications, but also not constrict the development of instrumented vertebrae,and avoid the crankshaft phenom-ena. PSPSS was proved to be a good choice to correct adolescent idiopathic scoliosis.