摘要
[目的]探讨脊柱侧凸后路CDH Legacy在脊柱侧凸后路矫形中的应用及其矫形效果。[方法]2003年7~8月,共有9例患者接受后路CDH Legacy矫形内固定加植骨融合手术,其中女7例,男2例;年龄11~18岁,平均13.5岁。病因学分类:青少年特发性脊柱侧凸(AIS)7例,先天性脊柱侧凸(CS)1例,神经纤维瘤病伴脊柱侧凸(NFI)1例。术前Cobb's角48^o~68^o,平均54^o。7例AIS和1例CS患者直接行一期后路CDH Legacy矫形内固定术,另1例NFI因Risser为0,先行一期前路骨骺阻滞再行二期后路CDH Legacy矫形固定。[结果]本组无死亡、感染,无神经系统并发症。未发生术中骨折及脊膜胸膜损伤。1例并发肠系膜上动脉综合征,给予禁食等保守治疗后症状缓解。手术时间210~300min,平均260min;出血量300~1000ml,平均700ml。术后Cobb’s角平均20^o,矫正率63%。本组随访20~30个月,平均23个月,随访1年时均获得骨性融合,无额状面或矢状面失偿,纠正丢失4^o,纠正丢失率7.4%。[结论]CDH Legacy在矫形效果与以往第3代内固定系统无明显差异,有操作简便、内固定牢固和选择多样性的特点。
[ Objective] To evaluate the surgical techniques and its clinical results of CDH Legacy in the treatment of seoliosis. [Method] Nine patients (7 female and 2 male) with seoliosis instrumented with posterior CDH Legacy system were recruited for this retrospective study. The etiological classification of scoliosis were idiopathic for 7, congenital for 1, neurofibromatosis (NFI) for 1. The average age was 13. 5 years (ranged 11 - 18 years). The average preoperative Cobb's angle was 54^o (ranged 48^o- 68^o). Seven AIS and one CS patients received one stage posterior CDH Legacy instrumentation; the NFI patients received one stage anterior epiphysiodesis and second stage posterior CDH Legacy instrumentation. [ Result ] There was no death, no infection and no neurological complication. No intra-operative fracture, no dura matter or pleuml laceration oc- curred. Superior Mesenteric Artery Syndrome occurred in one patients and recovered with conservative treatment. Posterior Cobb's angle averaged 20^o with correction rate of 63%. The duration of follow-up averaged 23 months ( ranged 20-30 months ). Surgical time averaged 260 min (ranged 210 -300 min) and mean EBL was 700 ml (300 - 1 000 ml). Bony fusions were achieved in all patients and no coronal or sagittal plane decompensation occurred. The loss of correction at last follow-up was 4^o with 7.4% loss of correction rate. [ Conclusion ] The clinical results of CDH Legacy are as good as the bther three generation implants, its advantage lies in lower profile, solid inter-locking, versatile implants and handy manipalation.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2007年第19期1441-1444,共4页
Orthopedic Journal of China
关键词
内固定
脊柱融合
脊柱侧凸
internal fixation
spinal fusion
scoliosis