后路半椎体全切术治疗青少年先天性脊柱侧凸畸形

Posterior hemivertebra resection in the treatment of teenagers with congenital scoliosis

目的评价后路半椎体切除治疗青少年半椎体所致先天性脊柱侧凸的临床疗效。方法回顾性分析2007-06-2011-06 21例青少年半椎体畸形采用一期后路半椎体全切除术患者的临床资料,均行后路半椎体切除加植骨融合钉棒内固定术。结果冠状面主弯cobb角术前平均为40.3°,术后平均为15.4°,末次随访平均为16.3°,矫正率为61.7%;矢状面后凸cobb角术前平均为33.3°,术后平均为11.8°,末次随访平均为12.6°,矫正率为64.5%;局部侧凸cobb角术前平均为36.2°,术后平均为14.7°,末次随访平均为15.3°,矫正率为59.3%。结论后路半椎体切除可去除病因,同时矫正冠状位和矢状位畸形,是治疗青少年半椎体引起的先天性脊柱侧凸的有效方法。

Objective To evaluate the clinical effect of teenagers with congenital scoliosis treated by posterior hemivertebra resection. Methods From June 2007 to June 2011,a total of 21 teenagers at the age of 10-18 with congenital scoliosis treated by posterior hemivertebra resection were reviewed. The average age at surgery was 14 years old. All the patients underwent posterior hemivertebra resection,fusion and correction with instrumentation. Results The average operation time was 2.5 hours （range 2-4 hours）,and the mean blood loss during operation was 650 ml （range 400-1200 m1）.The average follow-up period was 18 months（range 12-30 months）. Scolio-sis was corrected form 40.3°to 15.4°with a correction rate of 61.7%. Kyphosis was corrected form 33.3°to 11.8°with a correction rate of 64.5%.Mean Cobb angle of the segmental main curve was 36.2°before surgery,14.7°after surgery,and 15.3°at the latest follow-up. There was only one pedi-cle cutting without any sign of implant failure,pseudoarthrosis and correction loss. Conclusion Posterior hemivertebra resection can remove the cause directly,has a good capability of correcting deformity on the frontal and sagittal planes.