先天性脊柱侧弯采用后路半椎体切除短节段融合疗效分析

Curative Effect Analysis of Posterior Half Vertebral Resection Short Segmental Fusion in Congenital Scoliosis

目的：探讨先天性脊柱侧弯采用后路半椎体切除短节段融合治疗的临床疗效。方法：选取2011年1月~2014年1月经我院治疗的120份先天性脊柱侧弯患者,采用后路半椎体切除短节段融合治疗法进行治疗,比较手术前后、最后一次随访的脊柱全长正侧位X线片,测量并记录治疗前后及随访期间脊柱侧弯程度及后凸的Cobb’s角。结果：通过治疗患者脊柱侧弯得到明显改善,半椎体节段侧弯Cobb’s角术前平均44.2°,术后平均15.1°,平均矫正率为65.8%,末次随访平均14.3°,矫正率64.2%;全主弯Cobb’s角术后平均矫正率60.7%,末次随访平均矫正率65.6%;半椎体节段后凸Cobb’s角术前平均15.3°,术后为正常范围值;术后和末次随访的头侧、尾侧代偿弯改善明显,5项指标手术前后对比差异有统计学意义（P〈0.05）。结论：先天性脊柱侧弯采用后路半椎体切除短节段融合治疗可以达到显著矫正先天性脊柱侧弯的效果。

Objective： To investigate the clinical curative effect of posterior half vertebral resection short segmental fusion in congenital scoliosis. Methods： 120 children with congenital scoliosis were selected from January 2011 to January 2014 and given the posterior half vertebral resection short segmental fusion therapy. The results of lateral X ray film of spinal length was compared before and after treatment, and the scoliosis degree and the convex Cobb’s angle was measured before and after treatment and follow-up period.Results： After treatment, with the scoliosis was significantly improved, and the mean lateral Cobb’s angle of half vertebral segment section was 44.2 ° before operation, and 15.1 ° after operation, and the average correct rate was 65.8 %, in the last follow-up the mean value was 14.3 °, and the correct rate was 64.2 %. The postoperative average correct rate of all main bending Cobb’s Angle was 60.7%, The average correct rate in the last follow-up was 65.6 % and the mean Cobb’s angle of half vertebral segment posterior protrusion was 15.3 °, and after operation it was normal range value. The improvement of cranial and caudal compensatory bending was obvious after operation and in the last follow-up. There was statistical significance in comparison of these five indicators before and after surgery（P〈0.05）. Conclusions： Congenital scoliosis by posterior half vertebral resection short segmental fusion treatment can achieve the significant effect of correcting the congenital scoliosis, worthy of popularization in further clinical use.