上胸椎陈旧性后凸畸形并不全瘫的外科治疗

Surgical Treatment of Obsolete Upper Thoracic Spine Kyphosis with Incomplete Paralysis

目的探讨经肩胛下胸腔入路减压内固定治疗上胸椎陈旧性后凸畸形并不全瘫的价值.方法2000年1月～2004年1月对5例上胸椎陈旧性后凸畸形并不全瘫的病例,采用经肩胛下胸腔入路切除后凸椎体减压,取髂骨植骨,Ventrefix或Z-plate钢板内固定.结果5例术后胸腹部束带感消失,肌张力明显下降,肌力及下肢的感觉均有不同程度改善,患者主观观察满意.结论经肩胛下胸腔入路减压内固定术治疗上胸椎陈旧性后凸畸形,减压彻底,脊柱稳定重建可靠,疗效肯定.

Objective To investigate the value of surgical treatment of obsolete upper thoracic spine kyphosis with incomplete paralysis through transthoracic posterolateral approach decompression with internal fixation. Methods From January 2000 to January 2004, 5 cases of obsolete upper thoracic spine kyphosis with incomplete paralysis, were treated by resecting of kyphosised vertebrae, grafting procedure of harvesting iliac bone, Ventrefix or Z- plate internal fixation through transthoracic posterolateral approach. Results After operation, the loincloth- feeling disappeared, and the muscle tension decreased. The muscle strength and the feeling of the lower limbs all improved at different extent. The patients were satisfied with the curative effect. Conclusion with this method, the decompression is complete, and the spine reconstructed well. The curative effect of obsolete upper thoracic spine kyphosis with incomplete paralysis through transthoracic posterolateral approach decompression with internal fixation is ideal.