脊柱侧弯矫正术式的选择与评价

Selection and application of different instrumentations for scoliosis

目的 探讨如何正确选择脊柱侧弯的矫正手术方式。方法 回顾性分析讨论 1 993年以来应用哈 -鲁 (H-L)联合、CD、Zielke、中华长城系统及前后路联合技术矫正脊柱侧弯 1 4 8例的疗效 ,矫形原理 ,特点及临床应用情况。结果 均达到良好的矫正效果 ,平均矫正率 68.2 % ,术后随访矫正度有轻度丢失 ,合并症发生率低。结论 胸段脊柱侧弯宜选择 CD或 H— L手术 ,以 CD为首选 ;胸腰段和腰段侧弯适宜应用前路 Zielke或中华长城技术 ,严重脊柱侧弯与特发性king 、

Objective To study how to select the operative correction method for scolioss.Methods The effcicacy ,correction principle,characteristics and clinical application of Harrington Luque(H L),Cotrel Dubousset(CD),Zielke,Chinese Greatwall and Anterior posterior combined techniques in 148 cases of scoliosis since 1993 were retrospectively analysed.Results The correction effects were good;the average correction rate was 68,2%.There were different correction losses found in postopertive follow up,but the incidence rates of complications were low.Conclusion CD and H L methods are suitable for thoracic scoliosis.Furthermore,CD is the best way for thoracic scoliosis.Zielke and Chinese Greatwall techniques should be applied in the thoracolumbar and lumbar scoliosis;the correction of severe scoliosis and idiopathic scoliosis of King types ⅠandⅡshould be treated by Zielke and Chinese Greatwall techniques combined with posterior instrumentation.