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1、·338·中国矫形外科杂志 2004年3月第12卷第5期 OrthopJChin,Vol112,No15March2004·论 著·后路半椎体切除节段固定矫正侧后凸畸形疗效初步观察李 明 倪春鸿 朱晓东 赵新刚 刘 洋 杨洪平 白玉树 王善松 侯铁胜摘 要 目的:观察和评价由单个先天性半椎体引起的侧后凸畸形经一期后路半椎体切除及节段矫形内固定的初期手术效果。对象与方法:对10例由单个先天性半椎体引起的侧后凸畸形患者进行回顾性分析。年龄在8～14岁之间,均经一期后路半椎体切除及节段性矫形内固定。随访6个月～2年(平均1年2个月)。术前、术后及随访时摄站立位脊柱全长正侧位片进行
2、观察。结果:10例患者术前均有侧后凸畸形。术后侧凸角度由平均69°改善至28°(矫正率60%);后凸畸形由术前的平均48°矫正至平均19°。随访获初步或坚强融合,无神经系统损伤、感染及内固定失败等并发症发生。结论:由先天性半椎体所引起的脊柱侧后凸畸形可经一期后路半椎体切除和节段矫形内固定而获得满意的矫形效果。手术适应证为由胸椎或胸腰段半椎体畸形所引起的青少年患者的结构性侧后凸畸形。关键词 先天性侧后凸; 后路半椎体切除; 后路节段矫形中图分类号R68213文献标识码A文章编号 1005-8478(2004)05-0338-04Primaryclinicalresultsof
3、onestageposteriorhemivertebralresectionandsegmentalinstrumentationforhemivertebralkyphoscoliosis∥LIMing,NIChun2hong,ZHUXiao2dong,etal1OrthopedicDepartmentofChanghaiHospital,Shanghai200433AbstractObjective:Toevaluatethesurgicaloutcomeof10patientsofkyphoscoliosiswithhemivertebratreatedbyhemi
4、vertebralresectionbysingleposteriorapproachandcorrectionwithsegmentalposteriorinstrumentation1Methods:Atotalof10patientswithsinglehemivertebrabetweentheage8～14yearsunderwentoperativetreatmentwereevaluatedforaminimumof6months1Thetotalnumberofthehemivertebraresectedwere10casesT7(1patient),T9
5、(1patient),T10(1patient),T11(2patients),T12(3patients),L1(2patients)]1Afterposteriorhemivertebraresection,segmentalposteriorinstrumentationwithTSRH(8patients),CDHorizon(1patient)andIsola(1patient)systemwereusedforcorrectionofthekyphoscolioticdeformity1Radiographicevaluationwereconductedont
6、hepreoperative,postoperative,andfollow2upstandingposteroanteriorandlateralradiographs1Results:Allofthe10patientshadkyphoscolioticdeformity1Preoperativescoliosisaveraging69°wascorrectedto28°(Correctionrate,60%)1Preoperativekyphosisof48°wascorrectedto19°ofkyphosis1Trunkshiftof21mmimprovedto4
7、mm1Correctionlosswas3°inthefrontalplaneand2°inthesagittalplane,andnopatientsshowedmorethan6°ofcorrectionloss1Solidorprimaryfusionwereobtainedinallpatients1Noneurolog2icandsepticcomplications,implantfailurewereverifiedatthefinalradiographicevaluation1Conclusion
