青少年特发性脊柱侧弯凸侧旋棒矫形与凹侧旋棒矫形的手术效果评估Evaluation of corrective effect of adolescent idiopathic scoliosis patients treated by convex and concave rod derotation
黄紫房;杨军林;林翔;李佛保;谢超凡;王其飞;
摘要(Abstract):
[目的]比较青少年特发性脊柱侧凸(AIS)采用后路凸侧旋棒矫形与凹侧旋棒矫形的手术效果。[方法]收集本中心2008年7月~2011年7月收治的AIS患者61例,年龄10~18岁,术前主弯均<70°。按术中矫形技术分为凸侧旋棒矫形组(n=34)和凹侧旋棒矫形组(n=27),所有患者均具有完整的术前、术后全脊柱X线片。研究收集两组患者的术前、术后主弯Cobb角及其矫正率、T5~12后凸角、顶椎偏移距离(AVT)、C7偏离骶骨中央垂线距离(C7-CSVL)和C7偏离骶骨后上角距离(C7-SSVL),置钉密度,并进行统计学比较。[结果]两组患者皆成功获得手术矫正,术中、术后无严重并发症发生;术前主弯Cobb角分别从平均47.9°±9.9°和51.4°±8.8°(P=0.148),矫正至术后平均8.2°±5.2°和14.0°±8.5°(P=0.002),平均矫正率为(82.5±10.5)%和(73.4±13.9)%(P=0.005);T5~12后凸分别从术前平均17.7°±12.2°和20.6°±13.7°(P=0.377),矫正至术后平均19.7°±9.8°和18.3°±8.7°(P=0.558);术后冠状面和矢状面皆获得良好平衡。[结论]AIS后路凸侧旋棒矫形较凹侧旋棒矫形具有更好的主弯矫正率,并可潜在增加脊髓神经安全性;两组患者术后皆能维持良好的胸椎后凸。
关键词(KeyWords): 脊柱侧凸;矫形;凸侧;凹侧;旋棒技术
基金项目(Foundation):
作者(Author): 黄紫房;杨军林;林翔;李佛保;谢超凡;王其飞;
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DOI:
参考文献(References):
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