椎弓椎体楔形截骨治疗腰椎后凸伴不全瘫

Treatment of kyphosis with incomplete paralysis by osteotomy of the vertebro-arch and body

目的 观察经椎弓椎体楔形截骨治疗L1～ 3 后凸畸形伴不全瘫的疗效。方法 经椎弓椎体楔形截骨 ,行椎弓根螺钉加短Luque棒或Dick钉内固定。结果 平均随访 18个月 ,后凸角平均纠正42°。Frankel评分进步 1～ 2级 ,截骨处愈合。结论 该方法治疗L1～ 3 后凸畸形伴不全瘫 ,效果良好 ,但手术时间长 ,出血量大 ,易出现脊髓及大血管损伤 ,宜掌握好适应证。

Objective To observe effects of the treatment of L 1～3 kyphosis with incomplete paralysis by osteotomy of the vertebro arch body. Methods Osteotomy of the vertebro arch and body. Internal fixator used pedicle screw and Luques rod or Dicks nail. Results The average follow up period was 18 months. Frankel score improved 1～2 grade. The correction rate of kyphosis on average was 42°. The wound healed. Conclusion The method is an excellent tool for the kyphosis with imcomplete paralysis. However, it needed a longer operation time, there was a large amount of bleeding and the possibility of the injury of the spinal cord and blood vessel. The indicators should be selected properly.