椎体楔形截骨术在脊柱侧弯矫形中的应用

The clinical value of wedge vertebrectomy in scoliosis correction

目的:探讨椎体楔形截骨在脊柱侧弯矫形中的应用价值。方法:应用凸侧椎体楔形截骨、凹侧软组织松解、椎弓根系统内固定治疗脊柱侧弯23例,其中前路椎体截骨1例(开胸),后路椎体截骨22例。T10以上椎体截骨14个,最高处为T5,T10以下椎体截骨15个。20例脊柱侧凸畸形及3例先天性侧方半椎体侧凸畸形皆为椎体冠状面横行截骨。结果:术后随访时间4～36个月,平均19.2个月。术前Cobb氏角为65o～110o,平均为74.4o。术后测量的Cobb氏角为10o～35o,平均矫正率为76.5%;术后平均身高增长4.5cm。手术中失血为800ml～8200ml,平均1700ml。术后皆无神经系统及其他方面的并发症。结论:单一后路或前路椎体楔形截骨可有效矫正脊柱侧弯。

Objective:To evaluate the clinical value of wedge spondylectomy for the treatment of scoliosis through the posterior(22cases)or anterior approach(1case).Methods:The patients of scol-iosis were treated by wedge osteotomy,soft tissue brisement and pedicle fixation.The spondylectomy level(14vertebral bodys)of 14patients was above T 10 ,the highest one being T 5 .Vertebrectomy in coro-nal plane were performed in20cases of scoliosis and3cases of congential unilateral hemivertebra.Re -sults:The mean follow-up was19.2months(rang from4to36months).The preoperative,postoperative Cobb angle was65 o ～110 o (mean74.4 o ),10 o ～35 o respectively and corrective rate was76.5%.The patients were4.5cm taller on average after operation.The blood loss was800ml to8200ml(mean1700ml).No neurologic complications arose.Conclusion:The scoliosis deformity can be corrected effectively by wedge spondylectomy.