俄式内固定器械矫治脊柱侧凸的手术方法

Russian Style Instrumentation for Scoliosis

为力求手术方法简便、安全、效果可靠并且不影响儿童脊柱生长发育，采用俄式脊柱内固定器械矫治脊柱侧凸。共治疗特发性脊柱侧凸７例，年龄最大１５岁，最小７岁，男２例，女５例。术前Ｃｏｂｂ角最小３５°，最大７８°，旋转Ⅰ～Ⅲ度。随访２．５年。手术时Ｃｏｂｂ角３０～５０°者应用单板，大于５０°者应用双板。分别在侧凸的顶端两侧棘旁用梳子钢叉及椎板下的勾子将弹性钢板固定，撑开器作用下侧凸矫治满意后固定联接螺丝零件。矫正术后侧凸为８～１５°，矫正率达９５％，无脱勾、折板现象。经２．５年随访侧凸可进一步缩小２～５°。俄式内固定方法是脊柱侧凸治疗又一种新的治疗方法。其操作简便、安全，无需植骨融合脊柱及外固定。随着儿童生长发育侧凸矫正可持续进行，便于临床推广。但手术限于应用在特发性脊柱侧凸且柔韧性较好的患儿。

To introduce the Russian style instrumentation in the treatment for scoliosis,7 eases(male 2,female 5 )aged 7 to 15 years of idiopathic scoliosis were treated bv Russian style instrumentation.Preoperative Cobb's angle ranged 35-78°with rotation deformity of Ⅰ-Ⅲ grade.Single plate was applied to thase with Cobb's angle between 35-50°,while the double plate to Cobb's angle more than 50°,Paraspinous comblike forks and sublaminal hooks were fixed se,parately at appropriate vertebral levels of the two tope of scoliosis.Until the lower lateral curvature was spread for a satisfactory correction,the appliance was fixed tightly.The potoperative Cobb's angle ranged 8-15°,and the correction rate was 95% without dislodged hook or broken plate.Follow-up showed further reduction of Cobb's angle by 2-5°. This procedure is safe and simple. Neither bone graft nor external fixation on spinal fusion is required. Some further correction might be expected as the child grows up.It is suited for idiopathic scolioc,is with better flexibility.