后路全脊椎切除折顶矫形术治疗重度脊柱角状后凸

Treatment of Severe Angular Kypbotic Deformity with Unfolding Technique of Posterior Vertebral Column Resection

目的：评价后路全脊椎切除折顶矫形术治疗重度脊柱角状后凸畸形的安全性和临床初步效果.方法：采用后路全脊椎切除折顶矫形术治疗重度脊柱角状后凸畸形患者15例,其中先天性椎体形成不良9例,骨病治愈型胸腰椎结核3例,陈旧性脊柱骨折2例,神经纤维瘤病1例 合并神经损伤4例,其中Frankel C级1例、D级3例.术前矢状面角状后凸Cobb角 82°～150°,平均106°.结果：术后矢状面后凸Cobb角12°～45°,平均26.6°,矫正率75.8%.平均随访25.5个月,矫正度无显著丢失.所有患者获得良好的骨性愈合,无脊髓损伤.4例合并神经损害者术后6个月神经功能均恢复到Frankel E级.结论：全脊椎切除折顶矫形术治疗重度脊柱角状后凸畸形疗效满意,安全性好.

Objective ： To examine the safety and efficacy of unfolding technique after posterior vertebral column resection to correct severe angular kyphotic deformity. Methods：Fifteen patients with severe angular kyphotic deformity were surgically treated with unfolding technique after posterior vertebral column resection. There was congenital deformity in nine patients, old tuberculosis in three, old fracture in two, and neurofibromatosis in one. The local deformity was assessed with the Cobb method, the kyphosis ranged from 82° to 150° with an average of 106°. Results：The Cobbs angle in the sagittal plane was corrected from 106°to 26.6°, with correction rate of 75.8%. All patients were followed up among average 25.5 months. There were no correction loss or spinal cord deficits. Bony fustion was achieved in all patients. Four patients with preoperative neurologic deficits had recovered to Grade E of the Frankel grading system after six months of surgery. Conclusions ： It is satisfactory and safe to treat severe angular kyphotic deformity with the unfolding technique of posterior vertebral column resection.