单一后路半椎体切除结合椎间融合器治疗先天性脊柱畸形

Hemivertibra resection via posterior only approach together with interbody fusion in the surgical treatment of congenital spinal deformity

目的探讨经单纯后路半椎体切除结合椎间融合器在先天性脊柱畸形治疗中的应用及疗效。方法 2009年6月至2010年12月,6例先天性脊柱畸形患者行单纯后路半椎体切除,切除区域植入椎体间融合器,以此为支点,行后路椎弓根钉棒系统矫形,矫形区域行椎体间及后外侧融合。术后经过平均近12个月的随访。对术中出血、围手术期并发症、术后患者的影像学表现、临床症状等进行随访和评价。结果所有患者围手术期中均未发生血管、神经损伤等严重并发症。术后即刻影像学检查见半椎体切除彻底,脊柱侧后凸畸形矫正满意。随访中未见内固定失败及矫形丢失现象。结论后路切除半椎体畸形后,在缺损区域植入椎体间融合器,既可以帮助术中矫形,又可促进手术区域的融合和矫形的保持,减少假关节的发生和内固定的失败。

Objective To explore a method of using interbody fusion after the resection of hemivertibra via posterior only approach in the surgical treatment of congenital spinal deformity.Methods From June 2009 to December 2010,we had used interbody in the surgical treatment of congenital spinal deformity in 6 patients.After resection of the hemivertibra via posterior only approach,we put interbody together with autograft into the deformity area.Then we corrected the deformity with the pedicle screws-rod system and attempted to make interbody and post-lateral fusion of the surgical area.Till now about 12 months＇ follow-up had been finished.We discussed the surgical consequence and complications in the per-operative period.Results There are no severe complications in the per-operative period.In the post-operative radiological examination, we were satisfied with the correction.And we had not found any failure of the fixation and lose of correction during the follow-up.Conclusion Put the interbody with autograft in the area where the hemivertebra was resected,we had found it was helpful in the correction of the deformity and can promote the fusion of the surgical area.