后路半椎体切除联合椎弓根螺钉内固定治疗小儿先天性脊柱畸形的临床分析.doc

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1、后路半椎体切除联合椎弓根螺钉内固定治疗小儿先天性脊柱畸形的临床分析程跃(眉山市中医院四川眉山620000)【摘要】目的：分析后路半椎体切除联合椎弓根螺钉内固定治疗小儿先天性脊柱畸形的临床疗效。方法：以我院收治的32例先天性脊柱畸形患儿为研究对象，所有患儿均行后路半椎体切除联合椎弓根螺钉内固定治疗。术后予以患儿随访观察，拍摄全长脊柱正侧位X线片，测量Cobb角。同时，观察统计患儿术中及术后并发症的发生率。结果：本组32例患儿术后均获得良好的骨融合，躯体平衡效果佳。治疗前，患儿主弯冠状面Cobb角和主弯后凸Cobb角依次为(35.42&p

2、lusmn;3.24)°、(27.54±3.15)°；治疗后12个月,依次为(6.46±1.23)°>(4.38±0.83)°,均小于治疗前(P<0.05)；治疗后24个月，依次为(7.65±1.27)°、(4・95±1.02)°,均小于治疗前(P<0.05)o术后24个月，主弯冠状面Cobb角矫形率为78.40%,主弯后凸Cobb角矫形率为82.03%。术中发生胸膜损伤1例(3.13%)；术后发生切口浅表感染1例(3

3、.13%),无脊髓神经损伤、断钉、断棒、假关节形成等并发症发生。结论：后路半椎体切除联合椎弓根螺钉内固定矫正小儿先天性脊柱畸形的临床效果佳，整个手术过程中通过相关注意事项的把握可有效降低并发症，取得良好的内固定及骨融合效果。【关键词】小儿先天性脊柱畸形；后路半椎体切除；椎弓根螺钉内固定【中图分类号1R682.1【文献标识码1B【文章编号11003-5028(2015)8-0718-02Analysisofposteriorhalfvertebralbodyexcisionwithpediclescrewinternalfixation

4、inthetreatmentofchildrenwithcongenitalspinaldeformityclinicalcurativeeffect【Abstract]objective:toanalyzeposteriorhalfvertebralbodyexcisionwithpediclescrewinternalfixationinthetreatmentofchildrenwithcongenitalspinaldeformityclinicalcurativeeffect・Methods:ourhospital&rsqu

5、o;s32casesofchildrenwithcongenitalspinaldeformitywereastheresearchobject,andallpatientsweretreatedbyposteriorexcisionwithpediclescrewinternalfixation.Aftersurgeryandchildrenwerefollowed-up,thetotallengthofthespineX-raywastaken〃CobbAnglewasmeasured.Atthesametime,theincid

6、eneeofintraoperativeandpostoperativecomplicationsinchildrenwithwascounted・Results:32casesofpostoperativeobtainedgoodbonefusion,goodbodybalaneeeffect.Beforethetreatment,childrenwithprimarybendingcoronalCobbAngleandbendingafterconvexCobbAnglewas(35.42+3.24)°z(27.54-3.

7、15)°.12monthsaftertreatment,followedby(6.46+1.23)°z(4.38-0.83)°zwerelessthanbeforetreatment(P<0.05);24monthsaftertreatment,followedby(7.65+1.27)°,(4.95-1.02)°zwerelessthanbeforetreatment(P<0.05).24monthspostoperatively,thebendingofcoronalCobbAn

8、gleoforthopaedicratewas78.40%,themaincurvedconvexCobbAngleafterorthopaedicatarateof82.03%.Intraoperative,pleur