中国组织工程研究2016，Vol.20Issue(4)：529-533,5.DOI:10.3969/j.issn.2095-4344.2016.04.013
后路截骨矫形螺钉置入内固定修复胸腰段僵硬性角状后凸畸形：中期随访评价
Posterior pedicle subtraction osteotomy at the apical vertebra with transpedicular instrumentation in the treatment of rigid angular kyphosis of thoracolumbar spine：a medium-term curative effects
摘要
Abstract
BACKGROUND: During spinal orthopedic repair, the main difficulty is to maximize the correction of the deformity, simultaneously, to reduce the incidence of trauma and complications, especial y to avoid the corresponding spinal nerve injury. OBJECTIVE: To evaluate the curative effect of one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation in the treatment of rigid angular kyphosis of thoracolumbar spine. METHODS: We retrospectively analyzed the data of 42 cases of rigid angular kyphosis of thoracolumbar spine that were treated by one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation. Al patients received detailed imaging examination before and after operation. Kyphosis angle, Frankel grading and perioperative complications were recorded in al patients. X-ray films or CT films showed the bone graft fusion during fol ow-up. RESULTS AND CONCLUSION: Patients were fol owed up for 10-36 months after treatment. The average time of bone graft fusion was 5.1 months. Cobb’s angle of kyphosis was corrected from 78.4° (38°-110°) preoperatively to 7°(-8°-24°) at 10 days after treatment. The correction rate was 90%. The average angle during final fol ow-up was 7.9°, with an average loss of 0.9°. In 16 paresis patients, Frankel grading results showed grade B in 0 case, grade C in 3 cases, grade D in 5 cases, and grade E in 8 cases during final fol ow-up, showing significant improvement as compared with that pre-treatment (P < 0.05). Among 42 patients, 5 cases had complications. At 7 months after treatment, there were screw and titanium rod loosening at the distal end of the fusion segment in 1 case, cerebrospinal fluid leakage in 2 cases, transient double lower limb weakness in 1 case, pain in one side of lower limb in 1 case, and no severe complications appeared. These results verified that one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation could achieve satisfactory clinical outcomes in rigid angular kyphosis of thoracolumbar spine. The internal fixation was stable and with a high fusion rate and few complications. The medium-term effect was satisfactory.关键词
骨科植入物/脊柱植入物/截骨矫形/胸腰段/脊柱后凸/椎弓根内固定/国家自然科学基金分类
医药卫生引用本文复制引用
敖霜,贾一明,冷辉,赵宇,隋雨新,张皓..后路截骨矫形螺钉置入内固定修复胸腰段僵硬性角状后凸畸形：中期随访评价[J].中国组织工程研究,2016,20(4):529-533,5.基金项目
国家自然科学基金资助项目(81572093)，项目名称应用全外显子组测序结合代谢组学探索中国汉族人群胸椎黄韧带骨化症的致病基因@@@@ the National Natural Science Foundation of China, No.81572093 （81572093）
