椎弓根螺钉固定三维矫治特发性脊柱侧凸的疗效观察

Efficacy of pedicle screw technique for orthomorphia of idiopathic scoliosis

目的探讨椎弓根螺钉固定在特发性脊柱侧凸矫形术中的治疗效果。方法自2000年1月至2008年8月，对21例特发性脊柱侧凸患者行脊柱侧凸矫形术，术中采用徒手技术置入椎弓根螺钉行侧凸矫形，术后佩戴胸腰支具3～5个月。结果随访8～36个月，平均22个月。切口均获得Ⅰ期愈合。患者术前Cobb角平均为67．1°，术后Cobb角平均为25．4°，畸形矫正率为62％，随访中角度丢失平均为3．3°，身高平均增加约6cm。所有病例术中术后均无脊髓神经根损伤表现，均获得满意的脊柱融合。结论椎弓根螺钉固定能提供强大的三维矫正力，效果可靠、并发症少，应用椎弓根螺钉固定治疗特发性脊柱侧凸具有较好的临床效果。

Objective To investigate the efficacy of pedicte screw in the surgical treatment of idiopathic scoliosis. Methods From January 2000 to August 2008,21 patients with idiopathic scoliosis underwent orthomorphia by bare - handed pedicle screw placement, and were immobilized in a brace for 3 to 5 month after surgery. Results The mean follow - up period was 22 months（ range 8 - 36 months）. The average preoperative major curve was 67.1°, and the angle was 25.4° after surgery. The postoperative correction rate was 62%, and the mean loss of correction was 2.8 during the follow - up period. Body height was increased averagely by 6 cm. No nerves injury happened after surgery. All patients got satisfactory spinal fusion. Conclusion Pedicle screw has a great function in three - dimensional correction with a reliable effect and less complications. The application of this technique could gain a good effect of correction in orthomorphia of idiopathic scoliosis.