经后路手术切除内固定矫正治疗先天性半椎体畸形

Excision of hemivertebrae and deformity by segemental instrumentation from posterior approach for treatment of congenital hemivertebra deformities

目的回顾性分析4例由先天性半椎体造成的脊柱侧弯和后凸畸形经后路一次半椎体切除植骨固定矫正术的手术治疗效果。方法4例患者,半椎体的位置均在胸腰段,手术采用后路切口,切除半椎体后,内固定矫正畸形,植骨融合,术后平均随访时间为12月,术前、术后拍摄站立位的脊柱正侧位片。结果所有患者均有不同程度的侧弯和后凸畸形,侧弯角由术前的34°矫正至11°,后凸角由术前18°矫正至6°,躯干位移从15mm恢复至5mm,无任何手术并发症,无内固定断裂脱落,均融合。结论此手术方法对患有半椎体导致先天性脊柱畸形的患儿是有效、安全的方法。

Objective The retrospective evaluation is made to four cases of patients with kyphoscolosis due to congenital hemivertebrae,who had been undergone posterior hemivertebra resection and correction with segmental posterior instrumentation. Methods The hemivertebrae located at the thoracolumbar spine were operated through posterior approach to resect the hemivertebrae and to correct the deformity by segemental instrumentation. Results On follow up and the radiographs taken from standing posteroanterior position and lateral side showed that the mean Cobb＇s angle of scoliosis was corrected from preoperative 34^o into postoperative 11 ^o. The angle of kyphosis was improved fiom the preoperative 18^o to 6^oafter the surgery. There was no complication and the fusion was solid,without faliure of instrumentation. Conclusion The posterior hemivertebral resection and correction is a safe and effective method for the prepubertal children with the congenital hemivertebtae deformity.