临床骨科杂志2016，Vol.19Issue(4)：391-394,4.DOI:10.3969/j.issn.1008-0287.2016.04.003
后路截骨联合椎弓根内固定矫形治疗僵硬性脊柱侧后凸畸形
Posterior osteotomy combined with pedicle screw fixation in the treatment of rigid kyphoscoli-osis
曹云 1羊东 1彭五四 1卿培东1
作者信息
- 1. 绵阳市骨科医院脊柱科，四川 绵阳 621000
- 折叠
摘要
Abstract
Objective To explore the effect of the posterior osteotomy combined with pedicle screw fixation in the treatment of rigid kyphoscoliosis. Methods Twenty-six cases of rigid kyphoscoliosis patients were treated with poste-rior osteotomy and pedicle internal fixation. Eight cases underwent posterior ponte osteotomy, 13 cases underwent pedicle subtraction osteotomy with ponte osteotomy, and 5 cases were treated with vertebral columm resection. The changes of Cobb angle and the changes of C7 perpendicular bisector of the sacrum and the perpendicular distance were compared before and after operation and at the last follow-up. Results All the patients were followed up for 12~60 months. Preoperative Cobb angle of scoliosis was 30° ~135°(90. 7° ± 30. 6°), postoperative Cobb angle correction was 12°~30°(18° ± 5. 6°), correction rate was 82. 5%;in the last follow-up, which was 13°~32°(20° ± 5. 8°), lost rate was 4. 3%. Cobb angle of kyphosis was 20°~60°(40. 6° ± 18. 5°), postoperative Cobb angle was 10°~26° (16. 8° ± 6. 2°),correction rate was 85%;in the last follow-up, which was 13°~30°(20. 5° ± 7. 0°),lost rate was 3. 7%;C7 perpendicular bisector of the sacrum and the perpendicular bisector distance was 3. 8~ 6. 5 (5. 1 ± 1. 3) cm preopratively, the postoperative was 0. 3 ~1. 3 ( 0. 7 ± 0. 3 ) cm. At the time of the last follow-up, which was 0. 4~1. 7 (0. 8 ± 0. 3) cm. In all cases,no nerve injury and other complications was found. Only in 1 case,3 months after the operation,there was a loosening of internal fixation and bone fusion after prolonged fixation. Conclusions Adequate preoperative evaluation, selection of appropriate posterior approach, combined with pedicle screw fixation in treatment of rigid kyphoscoliosis can effectively correct the deformity and restore the sagittal balance.关键词
脊柱侧凸/脊柱后凸/椎弓根螺钉/截骨Key words
kyphosis/scoliosis/pedicle screw/osteotomy分类
医药卫生引用本文复制引用
曹云,羊东,彭五四,卿培东..后路截骨联合椎弓根内固定矫形治疗僵硬性脊柱侧后凸畸形[J].临床骨科杂志,2016,19(4):391-394,4.
