特发性脊柱侧凸手术方式的选择

Selection of surgical procedure for the treatment of idiopathic scoliosis

目的探讨和评价不同部位和程度的特发性脊柱侧凸手术方式的选择。方法175例特发性脊柱侧凸患者接受了矫正融合手术。按照畸形的程度和部位分为4组,分别采取不同的手术方法。各组患者的失血量、手术时间、矫正率、随访矫正丢失率及并发症均进行了分析比较。结果所有患者均安全完成手术,没有神经系统并发症的发生。侧凸矫正率分别为第1组81%;第2组86%;第3组68%;第4组72%。所有患者随访时间2年以上,平均为38个月(24～52个月)。结论根据脊柱侧凸畸形的程度和部位,正确选择适当的矫正方式,特发性脊柱侧凸可以获得满意的治疗效果。

Objectives To discuss and evaluate the selection of surgical procedure for the treatment of idiopathic scoliosis according to the location and degree of the deformity. Methods 175 patients with idiopathic scoliosis underwent surgical treatment with correction and fusion. The patients were divided into four groups according to the location and degree of the deformity and four different procedures were used for each group. For each group, the blood loss, surgery time, correction rate, loss of correction at final follow up and complications were compared and analyzed. Results All patients underwent surgery safely and no neurological complication occurred. The correction rate was 81% for Group I, 86% for Group II, 68% for Group Ⅲ and 72% for Group IV. All patients were followed up at least 2 years and the average time was 38 months (24～52). Conclusion Proper selection of surgical procedure according to the location and degree of the scoliotic deformity, satisfactory results can be achieved in the treatment of idiopathic scoliosis.