单纯经后路与经前路矫治脊柱半椎体畸形矫形效果的比较

Comparison of orthopedic effects of hemivertebra resection for congenital scoliosis: through single posterior approach and through anterior approach

目的比较单纯经后路和经前路切除半椎体短节段固定的近、远期手术矫形效果及并发症发生率。方法笔者对自2000-01—2013-06采用单纯经后路和经前路切除半椎体短节段固定治疗的脊柱半椎体畸形各8例进行回顾性分析。结果全部患者获得随访6~110个月,平均62.9个月。经后路(A组)与经前路(B组)侧凸Cobb角末次随访矫正率分别为(53.38±21.54)%、(23.75±21.18)%;后凸Cobb角末次随访矫正率分别为(56.86±11.88)%、(3.63±20.44)%。A组侧、后凸矫形效果及躯干平衡的恢复明显优于B组。所有患者围手术期无神经系统并发症发生,无伤口愈合不良、椎弓根切割、钉棒断裂等。末次随访时未见假关节形成及其他并发症发生。结论对于半椎体畸形所致先天性脊柱侧后凸畸形患者,采用后路半椎体切除椎弓根钉固定系统矫形效果确切,术中出血少、手术时间短,明显优于单纯经前路单钉棒固定手术的矫形效果。

Objective To compare orthopedic effects of hemivertebra resection for congenital scoliosis through single posterior approach and through anterior approach. Methods Retrospectively analysis of 16 cases of congenital scoliosis treated by hemivertebra resection through single posterior approach and anterior approach from Jan. 2000 to Jun. 2013, each 8cases. Results The average follow-up was 62.9 months ranging from 6 to 110 months. Single posterior approach(group A)and combined anterior and posterior approach(group B) the scoliosis latest follow-up correction rate was(53.38±21.54)%,(23.75±21.18)%;The kyphosis latest follow-up correction rate was(56.86±11.88)%,(3.63±20.44)%. Orthopedic effect: group A was better than group B. There were no major complications and no neurological damage. Conclusion Hemivertebra resection through single posterior approach is a safe and reasonable surgical option for congenital or kyphosis deformity, with less blood loss, shorter time, the orthopedic effect is better than anterior approach.