中华长城内固定系统在特发性脊柱侧凸中的应用(附11例初步报告)

The Application of China Great Wall System(CGWS) in Idiopathic Scoliosis:A Primary Report of 11 Cases

目的 :介绍中华长城内固定系统 (CGWS)在特发性脊柱侧凸畸形矫正治疗中的效果。方法 :自 1999年 11月起治疗 11例特发性脊柱侧凸畸形患者 ,年龄 12～ 18岁 ,Cobb′s角最小 42° ,最大 10 2° ,平均 64° ;2例伴有后凸畸形的Cobb′s角分别为 5 4°和 12 3°。采用CGWS经后路椎弓根钉内固定 ,去旋转三维矫形 ,同时胸廓成形和肋骨植骨脊柱融合。结果 :外观显著改善 ,脊柱在矢状面和冠状面的平衡重建满意 ,旋转畸形得到有效纠正和控制 ,Cobb′s角最小矫正5 3 .2 % ,最大矫正 10 0 % ,平均矫正 80 .2 % ;后凸平均矫正 68.5 %。 2例出院后发生椎弓钉突起部位压疮 ,其中 1例行翻修术。结论 :CGWS是一种新型的多功能脊柱三维矫形器械 ,具有材料优良 ,矫正效果显著 ,安装操作方便 ,固定牢固 ,安全可靠 ,有利于保持和重建脊柱平衡。缺点是钉尾略高 ,在上胸段易引起皮肤压疮 。

Objective:To introduce a new three dimension correction instrumentation called China Great Wall System(CGWS).Methods:Eleven cases have been corrected with this new technique since Nov.1999.There were 5 males and 6 females.The age ranged from 12 to 18 years (averaged 15.6 years).Of the eleven cases,3 type Ⅰ,1 type Ⅱ,4 type Ⅲ,3 type Ⅳ and 2 cases had kyphosis of 54 and 123 degree.The average preoperative Cobb's angle was 64 degree (range from 42 to 102),in frontal,while axial plane deformity (Nash Moe) range from Ⅱ to Ⅲ degree.Preoperative suspension traction of pelvis was performed 2～3 weeks.During operation,three dimension correction acquired by means of pedicle screw fixation,derotation,thoracoplasty and spinal fusion.Results:The appearance was improved obviously.The spinal balance was well maintained or restored and rotation was also significantly corrected.The average rate of correction was 80.2%(ranged from 53.2 % to 100%)and that of kyphosis was 68.5%.All patients had no nerve complications,while only two had pressure abrasion on the top of pedicle screw.Conclusion:China Great Wall System is a new universal system for the treatment of idiopathic scoliosis,it has various advantages such as high quality,material,convenient for fixation,stability,safety and well.Furthermore,the spinal balance is maintained during correction.The long term therapeutic effectiveness should be made further investigation.