后路椎体切除置入椎弓根钉棒系统内固定治疗先天性脊柱后侧凸畸形

Posterior vertebral resection and pedicle screw -rod system fixation for the treatment of congenital kyphoscoliosis

目的 探讨后路半椎体切除加椎弓根钉棒系统内固定治疗先天性脊柱侧凸的临床效果.方法 选择2008年12月～2011年12月收治的先天性脊柱侧凸患者15例,均为完全分节性半椎体畸形.患者均采用后路半椎体切除加椎弓根钉棒系统内固定治疗.术后随访,摄脊柱正侧位X线片,比较手术前后冠状面Cobb角及后凸角度矫正情况.结果 本组15例患者术前胸弯Cobb角为（52.4±10.6）°,末次随访为（14.6±6.4）°,矫正率为72.1％；术前腰弯Cobb角为（43.7±9.8）°,末次随访为（12.1±4.7）°,矫正率为72.3％；术前C7-CSVL为（6.3±4.6）cm,末次随访为（2.7±1.3）cm,矫正率为57.1％；各指标治疗前与末次随访比较差异均有统计学意义（P＜0.05）;所有患者术后均无脊髓损伤,术后均无感染,无内固定松动,无假关节形成无骨不连及植骨吸收等并发症发生.结论 后路半椎体切除加椎弓根钉棒系统内固定治疗半椎体畸形所致先天性脊柱侧凸安全、有效,矫正效果满意.

Objective To investigate the clinical effect of posterior hemivertebra resection and pedicle screw internal fixation system in treatment of children with congenital scoliosis. Methods 15 patients with congenital scoliosis in December 2008 to December 2011 were selected, all the patients were fully segmented hemivertebra deformity. Patients were treated with posterior hemivertebra resection and pedicle screw and rod system in the treatment. Postoperative follow-up, lateral spinal were taken radiograph, the coronal Cobb angle and kyphosis angle correction before and after operation were compared. Results Of the 15 patients, preoperative chest bent Cobb was （52.4±10.6）°, the last follow-up was （14.6±6.4）°, correction rate was 72.1%; surgery waist bending Cobb was （43.7±9.8）°, the last follow-up was （12.1±4.7）°, the correction rate of preoperative CT-CSVL were （6.3±4.6） cm, correction rate was 72.3%; the last follow-up were （2.7±1.3） cm, correction rate was 57.1%; the differences of indicators before treatment and final follow-up were statistically significant （P 〈 0.05）; there was no spinal cord injury in all patients after operation, no postoperative infection, no internal fixation loosening, no false joint formation without bone nonunion and bone absorption and other complications was found. Conclusion Posterior half vertebral resection with pedicle screw system internal fixation in the treatment of half vertebral deformity caused by congenital scoliosis is safety, effective, correction effect is satisfied.