后侧半椎体切除治疗先天性角状脊柱后凸

Post hemivertebrectomy for the treatment of congenital angular kyphosis

[目的]介绍先天性后侧半椎体切除术的适应证和手术方法。[方法]经后路暴露双侧的椎板,自双侧分离暴露关节突外侧和横突,切除横突沿椎弓根自骨膜下向前分离,暴露多余的后侧半椎体,切除多余的一节椎弓和后侧半椎体,自后路行双侧椎弓根螺钉加压棒固定。[结果]手术治疗先天性后侧半椎体畸形35例,取得优异的治疗效果,但手术操作比较复杂,相当于全脊柱截骨术的难度。[结论]先天性后侧半椎体切除术的年龄范围:8～25岁,年龄越大越趋向于作全脊柱截骨术。

[ Objective ] To introduce the operative methods and indications of congenital post hemivertebrectomy. [ Methods] Thirty -five cases of congenital post hemivertebra deformity received operation. The surgical procedure was as following： bilateral lamina was exposed through the post approach, the lateral articular process and transverse process were separated and exposed from bilateral, and the transverse process was resected and separated from subperiosteal forward along the pcdiele, surplus hemivertebra was finally exposed and a surplus vertebras was resected, then the bilateral internal fixation with pedicle screw compressive rod was finished through post approach. [ Results ] Good results were achieved in all cases, but the operative procedure was relatively difficulty, which is correspond to total spinal osteotomy. [ Conclusion ] The adaptive age for congenital post hemivertebrectomy is from 8 to 25 years. Total spinal osteotomy is needed if patient＇s age is marc than it.