一期前路手术治疗脊柱角状后凸畸形

Surgical treatment of angular spinal kyphosis with one stage anterior instrumented fusion

目的:探讨一期前路松解、椎管减压、植骨、内固定手术治疗脊柱角状后凸畸形的安全性和疗效。方法:1999年9月至2003年5月23例脊柱角状后凸畸形患者接受手术治疗,其中男9例,女14例,平均年龄27岁。先天性脊柱后凸14例,脊柱结核后凸畸形5例,外伤后脊柱后凸畸形4例。后凸Cobb角平均76°。所有患者均采用一期前路松解或椎管减压、椎体间植骨及钉-棒系统矫形固定治疗。结果:所有患者安全完成手术,无脊髓及神经根损伤等严重手术并发症,后凸平均矫正47°(矫正率61.8%)。术后随访平均24个月,植骨节段全部融合,融合时间平均为4.2个月。随访中82.6%的患者对治疗结果满意。结论:一期前路手术可有效地矫正脊柱角状后凸畸形,同时能行椎管减压和重建脊柱稳定性。

Objective:To evaluate the safety and feasibility of surgical treatment of angular spinal kyphosis with one stage anterior instrumented fusion.Method:From September 1999 to May 2003,23 cases of angular spinal kyphosis were treated surgically.There were 9 male and 14 female with an average age of 27 years. There were 14 cases of congenital kyphosis,5 cases of TB kyphosis and 4 cases of post-traumatic kyphosis. The average preoperative kyphosis was 76 degree.All patients underwent one stage anterior decompression,interbody fusion and screw-rod fixation.Result:All patients underwent surgery safely and no severe complications occurred.The average correction of kyphosis was 47 degree(61.8%).The average follow up was 24 months,solid fusion was obtained and the fusion time was 4.2 months in average.During the follow up,82.6% of the patients reported satisfaction with the surgery.Conclusion:One stage anterior instrumented correction and fusion can obtain adequate decompression and reconstruction of the spine.It is an effective surgical treatment for angular spinal kyphosis.