胸腔镜下前路松解联合后路矫形治疗脊柱畸形

Anterior thoracoscopic spine release followed by posterior instrumention in the treatment of spinal deformity

目的:评价胸腔镜下前路松解联合后路矫形对脊柱畸形的治疗效果。方法:回顾性分析我院收治的19例脊柱畸形行胸腔镜辅助前路松解及后路脊柱畸形矫形植骨融合术患者的临床资料及治疗结果。结果:胸腔镜手术时间平均120min,前路松解、阻滞椎间盘平均4.2个。术后14例特发性脊柱侧凸Cobb角平均被纠正到29.4°,4例神经纤维瘤病性脊柱侧凸Cobb角平均被纠正到28°,1例胸椎后凸Cobb角被纠正到58.5°。术后平均随访17.5个月,无矫正度的丢失和其它神经系统及血管损伤并发症。结论:胸腔镜辅助前路脊柱松解是安全、有效的微创手术,联合后路矫形治疗脊柱畸形可获得满意治疗效果。

Objective:To evaluate clinical results of thoracoscopic-assisted anterior release combined with posterior instrumentation in spinal deformity.Method:Nineteen patients of spinal deformities received thoracosocopic-assisted anterior relaxation and posterior instrumentation and fusion were retrospectively analyzed.Result:The average duration of the thoracoscopic procedure was 120 min,the average number of released levels was 4.2.Forteen scoliosis postoperative Cobb angle was correced to a mean of 29.4°,neurofibroma scoliosis postoperative Cobb angle was 28°,thoracic kyphosis postoperative Cobb angle was 58.5°.All patients were followed up for 17.5 months in average.No neurologic or vascular complications occurred and no loss of correction angle.Conclusion:Thoracoscopic anterior spinal surgery is a safe and effective technique for the treatment of spinal deformity,it can avoid complication by tranditionl thoracic surgery,and combined with posterior instrumentation and can establish well clinical results for the treatment of the spinal deformity.