先天性脊柱侧凸合并高肩胛症的手术治疗

Surgical treatment of congenital scoliosis with Sprengel's deformity

目的探讨儿童先天性脊柱侧凸合并高肩胛症的手术治疗方法。方法在我院住院手术治疗的先天性脊柱侧凸合并高肩胛症患者9例,术前行脊柱正侧位片及脊柱螺旋CT检查。位于脊柱凸侧的高肩胛症一期行肩胛下移及脊柱侧凸矫形手术,位于脊柱凹侧的高肩胛症由于脊柱上胸段侧凸不著而暂未行脊柱矫形手术,仅行肩胛下移术。术后间隔3个月到半年复查。结果随访检查显示脊柱侧凸进展得以控制,高肩胛症无复发,患者术后无因下移肩胛骨及矫正脊柱侧凸引起的神经症状。结论先天性脊柱侧凸可合并高肩胛症,对于脊柱凸侧合并高肩胛症行脊柱侧凸矫正手术同时行肩胛下移手术,对于脊柱凹侧合并高肩胛症行肩胛下移术,取得了很好的治疗效果。

Objective To discuss the surgical treatment of congenital scoliosis with Sprengel＇s deformity in children.Methods Nine children of congenital scoliosis with Sprengel＇s deformity were treated in our hospital.Scoliosis patients who had Sprengel＇s deformity in convex side were underwent spinal and scapular surgery（modified Woodward）,patients in concave side were underwent scapular surgery（modified Woodward）.All patients were assessed clinically and radiographically pre-and post-operation.Result Follow-up examination showed the scoliosis progress controled,high scapula no relapse of postoperative patients,no neurological deficits caused by correction of scapula and correction of scoliosis.Conclusions Congenital scoliosis can combine with Sprengel＇s deformity.Patients with Sprengel＇s deformity in spinal convex side need both spinal and scapular surgery,patients with Sprengel＇s deformity in concave side may just need scapular surgery.They both have achieved effective treatment.