脊柱前后入路治疗先天性脊柱侧凸

Anterior and Posterior Approach for congenital Scoliosis

为了提高手术治疗小儿先天性脊柱侧凸的矫正率，减少术后畸形复发和曲轴现象的发生，采用脊柱前后入路手术治疗小儿先天性脊柱侧凸１５例。平均手术年龄９岁，Ｃｏｂｂ角平均８０°，平均随访４年。与同期２５例因先天性脊柱侧凸行单纯脊柱后路矫形术患儿进行术后平均矫正率、矫正丢失度／年、有无曲轴现象等临床指标比较。结果显示脊柱前后入路组治疗效果明显优于单纯脊柱后路组。对患有严重脊柱侧凸、弧度僵硬或并发后凸的患儿，宜行脊柱前后入路手术，对已行单纯脊柱后路矫形的患儿，应定期随访，如手术失败或畸形复发，有必要再次行脊柱前后入路矫形融合术。

Abstract In order to increase the correction rate and prevent the further curving or the crankshaft phenomenon,15 children with congenital scolioc,is were treated by the procedure of anterior-posterior(A-P)approach.Before surgery,the average degree of Cobb's angle was 80°.The average age at surgery was 9 years and the average time of follow-up was 4 years. The results of A-P approach were compared with those of the conventional posterior spinal fusion on 25 cases,A good correction and stability of the spine were obtained in the A-P group.It is stressed that assassment of growth potential in the anterior portion of the spine should be attempted.In cases,of severe scoliosis or scolicosis with kyphosis the A-P approach is necessary.For those treated by poterior spine fusion alone,a careful follow-up is required. Whenever the deformity