全脊柱截骨USS系统内固定治疗脊柱后凸

SURGICAL TREATMENT OF KYPHOSIS WITH UNIVERSAL SPINE SYSTEM

目的 观察一次性多平面全脊柱截骨配合通用脊柱内固定系统 (USS)内固定治疗脊柱后凸的疗效。 方法 2 0 0 0年 1月～ 2 0 0 2年 9月对 31例脊柱后凸患者进行了手术治疗 ,其中休门氏病 2例 ,强直性脊柱炎伴脊柱后凸 2 9例 ;病程 6～ 2 8年。X线片示脊柱后凸角 (Cobb角 )平均 89°,其中小于 4 0°3例 ,4 0～ 80°17例 ,80～ 110° 9例 ,大于110°2例 ,平均 89°。将术后平均矫正度数与术前平均后凸角度进行对比求出平均矫正率 ,并对截骨融合率、内固定结构稳定性进行随访统计。 结果 术后 31例均获 6～ 31个月随访 ,平均 12个月。术后 Cobb小于 4 0° 3例 ,平均矫正 32°;4 0～ 80°17例 ,平均矫正 5 8°;80～ 110°9例 ,平均矫正 86°;大于 110°2例 ,平均矫正 12 0°。术后全组平均矫正 74°,平均矫正率为 83.15 % ;除 1例截骨平面近椎间盘未愈合 ,余 30例术后 3～ 6个月获得骨性愈合。无一例发生断钉、断棒及连接结构松脱。 结论 采用一次性多平面全脊柱截骨配合 USS系统内固定治疗脊柱后凸可达到稳定的三维固定 ,增加了脊椎融合率 ,提高了后凸角度矫正率 ,并可早期离床活动 ,无须外固定。

Objective To introduce a method to treat kyphosis with universal spine system (USS) and to evaluate its clinical effect. Methods From January 2000 to September 2002, 31 patients with kyphosis were treated with 'one stage total vertebral wedge shaped osteotomy' and internal fixation of USS. The average follow up time was 12 months ( 6 31 months). We observed the clinical effect with the spinal column Cobb before operation and after operation, and the osteotomy confluence rate. Results In 31 patients, the average angle ( Cobb ) was 89° before operation and 74° after operation; the average rate of correction was 83.15% and the average rate of osteotomy confluence was 96 77%. No screw and rod broke and loosened. Conclusion The USS is the reliable internal fixation instrument for the treatment of kyphosis, can increase the osteotomy confluence rate and improve correcting rate.