青少年胸椎半椎体脊柱侧凸合并脊髓纵裂的手术治疗Surgical treatment of scoliosis of thoracic hemivertebra and diastematomyelia of adolescent
邢文华;霍洪军;肖宇龙;杨学军;赵岩;付裕;
摘要(Abstract):
[目的]探讨青少年胸椎半椎体脊柱侧凸合并脊髓纵裂的手术方法及治疗效果。[方法]2001年1月~2007年6月应用一期后路半椎体及骨嵴切除、椎弓根螺钉内固定植骨融合治疗15例患者,男6例,女9例;年龄16~24岁,平均21.2岁。15例均为完全分节半椎体,半椎体位置T113例、T1212例。术后观察脊柱融合、畸形矫正率及内固定稳定情况。[结果]随访19~45个月,平均34个月,术前Cobb’s角平均为52.3°±3.8°,术后为10.2°±1.4°,末次随访有1.6°的角度丢失,身高平均增加3.76cm。均获得良好骨融合,融合时间3~5个月,平均3.6个月。无内固定失败及假关节形成。[结论]一期后路半椎体及骨嵴切除、椎弓根螺钉内固定植骨融合术是治疗青少年胸椎半椎体脊柱侧凸合并脊髓纵裂的有效方法,具有较好植骨融合和稳定性,值得推广应用。
关键词(KeyWords): 先天性脊柱侧凸;脊髓纵裂;半椎体;内固定
基金项目(Foundation):
作者(Author): 邢文华;霍洪军;肖宇龙;杨学军;赵岩;付裕;
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DOI:
参考文献(References):
- [1]Bollini G,Docquier PL,Viehweger E.Thoracolumbar hemivertebrae resection by double approach in a single procedure:long-term follow-up[J].Spine,2006,15:1745-1757.
- [2]Ginsburg G,Muleonrey DS,Browdy J.Transpedieular hemiepiphys-iodesis and posterior instrumentation as a treatment for congenital seo-liosis[J].J Pediatr Orthop,2007,4:387-391.
- [3]Shono Y,Abumi K,Kaneda K.One-stage posterior hemivertebra re-section and correction using segmental postertior instrumentation[J].Spine,200l,7:752-757.
- [4]Ruf M,Harms J.Hemivertebra resection by a posterior approach:inno-vative operative technique and first results[J].Spine,2002,10:1116-1123.
- [5]McMaster MJ.Spinal growth and congenital deformity of the spine[J].Spine,2006,20:2284-2287.
- [6]李明,倪春鸿,朱晓东,等.后路半椎体切除节段固定矫正侧后凸畸形疗效初步观察[J].中国矫形外科杂志,2004,5:338-341.
- [7]Ginsburg G,Muleonrey DS,Browdy J.Transpedieular hemiepiphys-iodesis and posterior instrumentation as a treatment for congenital seo-liosis[J].J Pediatr Orthop,2007,4:387-391.
- [8]Hedequist DJ.Surgical treatment of congenital scoliosis[J].Orthop Clin North Am,2007,4:497-509.
- [9]王金光,郑启新,郭晓,等.青少年先天性半椎体脊柱侧凸畸形的手术治疗[J].中国矫形外科杂志,2005,24:1864-1866.