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对KingⅡ型特发性脊柱侧凸是行选择性胸椎融合还是非选择性融合? 被引量:1
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作者 仉建国 《中国脊柱脊髓杂志》 CAS CSCD 2003年第5期268-269,共2页
随着骨科矫形器械的发展,脊柱侧凸三维畸形通过手术一次性获得矫正成为可能。但在保证良好矫形的同时,如何实现更短节段的固定融合,以保留更多的脊柱活动功能,仍是目前存在的问题。这除关系到前、后路手术的选择外,融合节段的选择,特别... 随着骨科矫形器械的发展,脊柱侧凸三维畸形通过手术一次性获得矫正成为可能。但在保证良好矫形的同时,如何实现更短节段的固定融合,以保留更多的脊柱活动功能,仍是目前存在的问题。这除关系到前、后路手术的选择外,融合节段的选择,特别是对KingⅡ型脊柱侧凸患者融合节段的选择尚存在不同认识。本期邀请了部分专家对此进行讨论,以期对读者有所启迪与帮助。 展开更多
关键词 King-Ⅱ型特发性脊柱侧凸 选择性胸椎融合 选择性融合 手术治疗
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不同内固定物组合形式对青少年特发性脊柱侧凸后路选择性胸椎融合矫形效果的影响
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作者 仉建国 于斌 +8 位作者 邱贵兴 王以朋 赵宇 沈建雄 赵宏 余可谊 李其一 杨新宇 赵丽娟 《中国骨与关节外科》 2008年第1期21-26,共6页
目的分析比较采用不同内固定物组合形式对青少年特发性脊柱侧凸患者行后路选择性胸椎融合的矫形效果。方法根据内固定物组合形式的不同将患者分为三组:组A:内固定钩组;组B:混合组(内固定钩+椎弓根螺钉);组C:全节段椎弓根螺钉组分析比较... 目的分析比较采用不同内固定物组合形式对青少年特发性脊柱侧凸患者行后路选择性胸椎融合的矫形效果。方法根据内固定物组合形式的不同将患者分为三组:组A:内固定钩组;组B:混合组(内固定钩+椎弓根螺钉);组C:全节段椎弓根螺钉组分析比较三组患者的矫形效果。结果:共57例患者,组A 9例,组B 30例,组C 18例。平均年龄14.3岁,平均随访时间19.6个月。三组患者主胸弯冠状面Cobb角术前分别为49.0°、48.8°和47.4°,术后分别矫正到15.1°、13.7°和6.8°,随访时分别为19.0°、17.0°和9.5°,胸弯矫形率分别为62.1%、64.6%和79.0%,矫形率组C优于组A与组B(P=0.014,P=0.003),组B与组A比较差异无统计学意义(P=0.688);术前腰弯冠状面Cobb角分别为32.4°、32.6°和35.2°,术后分别矫正到12.0°、8.6°和8.3°,随访时分别为16.3°、10.3°和11.1°,随访时腰弯自动矫形率分别为48.9%,66.8%和69.9%,矫形率组B与组C优于组A(P=0.012,P=0.008),组C优于组B(P=0.003)。结论不论使用何种内固定物组合形式,主胸弯和腰弯均可获得良好的矫形效果,但全节段椎弓根螺钉固定组胸弯和腰弯矫形效果更佳。 展开更多
关键词 特发性脊柱侧凸 选择性胸椎融合 内固定器 椎弓根螺钉
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青少年特发性脊柱侧凸的选择性胸椎融合治疗 被引量:13
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作者 仉建国 邱贵兴 +5 位作者 王以朋 翁习生 于斌 徐宏光 杨新宇 任玉珠 《中华外科杂志》 CAS CSCD 北大核心 2004年第4期216-219,共4页
目的 探讨青少年特发性脊柱侧凸选择性胸椎融合治疗的适应证。方法 回顾性分析12例行选择性胸椎融合患者术前、术后及随访时的X光像 ,对侧凸类型、侧凸Cobb角、顶椎旋转度、顶椎偏距、侧凸柔韧性、躯干偏移及胸腰段矢状面Cobb角进行... 目的 探讨青少年特发性脊柱侧凸选择性胸椎融合治疗的适应证。方法 回顾性分析12例行选择性胸椎融合患者术前、术后及随访时的X光像 ,对侧凸类型、侧凸Cobb角、顶椎旋转度、顶椎偏距、侧凸柔韧性、躯干偏移及胸腰段矢状面Cobb角进行测量和分析。患者 12例中男 2例 ,女10例 ,平均年龄 15 1(13~ 18)岁。侧凸均为KingⅡ型 ,其中PUMCⅡb1型 9例 ,Ⅱc3型 3例。所有病例均行选择性胸椎融合 ,平均随访 3 5 (1~ 10 5 )年。结果 手术前后胸弯冠状面Cobb角分别为5 4 0°、19 0° ,平均矫正率 6 2 7% ;腰弯冠状面Cobb角分别为 34 6°、12 5° ,自动矫正率为 6 4 7%。最后随访时 ,胸、腰弯的冠状面Cobb角分别为 18 8°、15 9°;腰弯冠状面Cobb角、顶椎偏距及顶椎旋转度与术后相比无显著变化。术后发生胸腰段后凸 1例 ,最终随访时未见进一步加重。无躯干失平衡现象发生。选择性胸椎融合较后路融合双弯平均减少 3 5个融合节段。结论 对腰弯柔韧性好且度数较小的KingⅡ (PUMCⅡb1和部分Ⅱc3)型特发性脊柱侧凸 。 展开更多
关键词 青少年 特发性脊柱侧凸 选择性胸椎融合 治疗 适应证
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Posterior Selective Thoracic Fusion in Adolescent Idiopathic Scoliosis Patients:a Comparison of All Pedicle Screws versus Hybrid Instrumentation 被引量:9
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作者 Bin Yu Jian-guo Zhang Gui-xing Qiu Yi-peng Wang Yu Zhao Jian-xiong Shen Hong Zhao Xin-yu Yang 《Chinese Medical Sciences Journal》 CAS CSCD 2009年第1期30-35,共6页
Objective To analyze the influence of segmental pedicle screws versus hybrid instrumentation on the correction results in adolescent idiopathic scoliosis patients undergoing posterior selective thoracic fusion. Metho... Objective To analyze the influence of segmental pedicle screws versus hybrid instrumentation on the correction results in adolescent idiopathic scoliosis patients undergoing posterior selective thoracic fusion. Methods By reviewing the medical records and roentgenograms of adolescent idiopathic scoliosis patients who underwent selective thoracic fusion from February 2000 to January 2007 in our hospital, the patients were divided into 2 groups according to different instrumentation fashions: Group A was hook-screw-rod (hybrid) internal fixation type, Group B was screw-rod (all pedicle screws) internal fixation type, and the screws were used in every segment on the concave side of the thoracic curve. The parameters of the scoliosis were measured and the correction results were analyzed. Results Totally, 48 patients (7 males, 41 females) were included, with an average age of 14.4 years old and a mean follow-up time of 12.3 months. Thirty and 18 patients were assigned to group A and group B, respectively. The mean preoperative coronal Cobb angles of the thoracic curve were 48.8° and 47.4°, respectively. After surgery, they were corrected to 13.7° and 6.8°, respectively. At final follow-up, they were 17.0° and 9.5°, with an average correction rate of 64.6% and 79.0%, respectively, and the correction rate of group B was significantly higher than that of group A (P=0.003). The mean preoperative coronal Cobb angles of the lumbar curve were 32.6° and 35.2°, respectively. After surgery, they were corrected to 8.6° and 8.3°, respectively. At final follow-up, they were 10.3° and 11.1°, with an average correction rate of 66.8% and 69.9%, respectively, and the correction rate of group B was significantly higher than that of group A (P=0.003). The correction loss of the thoracic curve and lumbar curve in the 2 groups were 3.1° and 1.8°, 2.4° and 2.4°, respectively. No significant difference was noted (both P〉0.05). The decompensation rate at final follow-up in these 2 groups were 4% (1/25) and 7.1% (1/14) respectively, with no significant difference (P〉0.05). 展开更多
关键词 adolescent idiopathic scoliosis selective thoracic fusion internal fixator pedicle screw DECOMPENSATION
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