一期后路经椎弓根“蛋壳”技术治疗青少年先天性半椎体畸形的疗效分析

Effect analysis of congenital deformity of hemivertebra in youngsters by progress of one-stage posterior eggshell procedure

目的评价一期后路经椎弓根"蛋壳"技术半椎体切除治疗青少年先天性半椎体畸形的临床疗效。方法 2009-03-2013-05,一期后路经椎弓根"蛋壳"技术半椎体切除治疗青少年先天性半椎体畸形患者11例,评价Cobb角矫正情况、融合情况、临床疗效、手术并发症。结果无内固定断裂脱出,均获得骨性融合,无明显矫正丢失。侧凸Cobb角由术前平均平均(45.3±14.5)°矫正到术后平均(17.2±7.4)°,平均矫正28.1°,矫正率62.0%。后凸Cobb角由术前平均(39.6±8.4)°矫正到术后平均(16.2±8.2)°,平均矫正23.4°,矫正率40.9%。侧凸、后凸Cobb角手术前后比较均有统计学差异(P<0.05)。结论一期后路经椎弓根"蛋壳"技术治疗青少年半椎体畸形,融合率高,并发症少,是一种较好的治疗方法。

Objective To investigate the therapeutic effect of congenital deformity of hemiverte- bra in youngsters by progress of one-stage posterior eggshell procedure. Methods From March 2009 to May 2012,11 cases of congenital deformity of hemivertebra were treated by progress of one-stage posterior eggsheU procedure, to evaluate thoracic-waist cobb angle,bone healing condi- tion,curative effect,internal fixation location and operational complications. Results No death and infection occurred, dural tear in 1,transient paresis in 2. All patients were followed up for 15-60 months,Visual Analogue Scale degraded averagely 5.3,Kyphosis deformity was rectified with average rectification angle of thoracic-waist cobb angle was 30.5°（P〈0.05）. The bone fusion was achieved, no fracture or looseness of internal fixation. Conclusion The treatment for thoracolumbar kyphosis deformity caused by oboslete fracture obtained satisfactory the orthopedic effect and curative effect by transpedicular wedge osteotomy.