刘祥胜;朱晓东;白玉树;吴大江;吴冰;易红蕾;李明;王达义;

• 1:第二军医大学附属长海医院骨科
• 2:湖北医药学院附属太和医院脊柱外科

摘要(Abstract)：

[目的]对Ponte截骨与Smith-Petersen截骨(SPO截骨)治疗僵硬性青少年特发性胸椎侧凸的临床疗效及影像学结果进行回顾性比较。[方法]2007年5月～2009年3间收治的单纯后路全椎弓根螺钉系统矫正僵硬性青少年特发性胸椎侧凸的手术病例58例,其中36例行SPO截骨,22例行Ponte截骨。通过影像学检查对两组的手术效果和躯干平衡情况进行分析,末次随访时用中文版SRS-22量表进行患者的健康生存质量评价。[结果]两组患者的性别比例、手术时年龄、Risser征、融合节段数、置钉密度、术前冠状面胸主弯Cobb角无显著性意义(P>0.05)。Ponte截骨组的术后3个月冠状面胸主弯Cobb角矫正率明显大于SPO截骨组,分别为67.1%和56%(P<0.05)。末次随访时两组矫正率得到很好的维持,分别为61%和50.5%(P<0.05)。两组的术前、术后腰椎代偿性次弯Cobb角无显著性差异。两组的术前胸椎后凸Cobb角分别为20.6±8.5°和22.3±10.5°,术后3个月胸椎后凸角SPO截骨组比术前平均增加1.2°,Ponte截骨组比术前平均丢失1.4°,末次随访SPO截骨组胸椎后凸角比术前平均增加1.9°,Pon-te截骨组比术前平均丢失2.9°,两组间比较无显著性差异(P>0.05)。两组的次要并发症无显著性差异(P>0.05),两组均未发生主要并发症。[结论]多节段Ponte截骨能提高僵硬性青少年特发性胸椎侧凸冠状面胸主弯Cobb角的手术矫正率,并不增加并发症的发生率,而且能提供更多的局部自体植骨量、增加植骨融合面积。

关键词(KeyWords)： 僵硬性青少年特发性胸椎侧凸;Ponte截骨;Smith-Petersen截骨;全椎弓根螺钉系统

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 刘祥胜;朱晓东;白玉树;吴大江;吴冰;易红蕾;李明;王达义;

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