脊柱畸形矫形中预防脊髓损伤的近期研究进展

Research advances of spinal cord injury prevention in the spinal deformity correction

重度脊柱畸形往往需要行截骨矫形术，而矫形术中最大的风险就是损伤脊髓，出现截瘫等严重并发症。然而，目前对于如何在矫形过程中最大限度地避免脊髓损伤，有关的理论研究较少。目前认为脊柱截骨矫形过程中引起脊髓损伤的机制主要有两方面，一是机械性损伤导致的直接性脊髓功能障碍，二是脊髓缺血导致的间接性神经功能损害。

Osteotomy correction is often required in the treatment of severe rigid spinal deformity. The most threatening risk is spinal cord injury which can result in catastrophic outcomes including paraplegia. The injury of spinal cord can be attributed to two main aspects： direct detriment by mechanical factors, indirect impairment after ischemia. In recent years, intraoperative spinal cord monitoring and digital orthopedic technology guiding screw implantation and osteotomy design have been recommended to improve the safety. In addition, the impact of the morphological change on spinal cord function has been reported.