张宏其;肖力戈;唐明星;郭超峰;刘金洋;邓盎;王昱翔;刘少华;

• 1:中南大学湘雅医院脊柱外科湘雅脊柱外科中心

摘要(Abstract)：

[目的]探讨一期后路短节段融合内固定、二期前路病灶清除椎间植骨治疗幼儿腰椎结核伴后凸畸形的手术方法和疗效。[方法]2006年1月~2014年6月,本院共收治年龄<7岁患有腰椎结核并后凸畸形的患儿共17例,其中男性9例,女性8例,年龄4~7岁,平均5.1岁。均采用后路一期钉棒内固定植骨融合,前路二期病灶清除椎间钛网植骨融合术治疗。观察比较患者术前术后及末次随访的节段后凸Cobb角变化,评估植骨融合情况及神经功能情况。[结果]所有病例均获得随访,随访时间10~42个月。Cobb角由术前(24.18±7.15)°减少至术后(0.12±4.24)°,差异有统计学意义(P<0.001);末次随访节段后凸(0.65±3.92)°,与术前比较差异有统计学意义(P<0.001),但与术后比较差异无统计学意义(P=0.269)。JOA评分由术前(21.53±5.04)分增加至术后(28.06±0.90)分,差异有统计学意义(P<0.001)。末次随访时,17例患者ASIA分级均恢复到E级。随访期间均未发现内固定松动、脱出、移位、断裂。[结论]对低龄儿童脊柱结核合并后凸畸形,采用一期后路短节段固定植骨融合合并二期前路病灶清除钛网植骨融合可以取得较好的疗效。

关键词(KeyWords)： 脊柱结核;腰椎;后凸畸形;幼儿;分期手术

Abstract:

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作者(Author): 张宏其;肖力戈;唐明星;郭超峰;刘金洋;邓盎;王昱翔;刘少华;

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