多节段全脊椎截骨术矫正脊柱后凸畸形

Multi-segment osteotomy of total spinal vertebral for correction of kyphosis

作者自１９８５年６月至１９９０年６月应用自行设计的脊柱截骨器械，行多节段全脊椎截骨矫正脊柱后凸畸形共３４４例。该手术与传统的脊柱截骨术比较有以下几个优点：（１）、全脊椎截骨术，截骨间隙能自然对合，接触面积大，稳定性强，愈合快。（２）、由于相邻椎体前缘不张开，可避免大血管损伤．（３）、以后凸顶点为截骨中心，符合矫形几何学和运动力学．（４）、截骨最高部位达胸１０，突破了胸椎不宜截骨的禁区，提高了矫正效果。本组手术矫正度为３５°～１００°，平均５６．７°。平均矫正率６９．９％，优于传统的手术方法。

Multi-segment osteotomies of total spinal vertebral was performed on 344 cases with kyphosis. resecting not only the posterior elements but also the adjacent portions of the vertebral bodies. This operative procedure carried following advantages: the anterior longitudinal ligament remained intact, and the anterior border of the intervertebral space, was not opened, therefore, it would not be complicated by a neuro-vascular injury after completion of the correction. The contact area of the bone after correction was also increased, rendering the osteotomy sited more stable with the slightest possibility of slipping. Bony unionwas also facilitated. The highest level of osteotomy was T10. The mean angle of kyphosis in this series was 83. 7 degrees before operation. The average correction was 56 7 degrees; The average correction rate was 69.9%