后路小切口多次分期延长联合终末矫形融合术治疗小儿脊柱侧凸16例报告

发布时间：2018-03-15 02:20

本文选题：小儿脊柱侧凸　切入点：手术治疗　出处：《中国矫形外科杂志》2017年09期 　论文类型：期刊论文

【摘要】：[目的]观察后路小切口分期延长联合终末矫形内固定融合术治疗小儿脊柱侧凸的临床疗效和安全性。[方法]2007年3月~2015年5月共16例小儿脊柱侧凸在本院接受后路小切口多次分期延长并全部完成终末矫形融合手术。其中先天性10例,早发型5例,神经纤维瘤病1例。对所有病例的临床数据和影像学资料进行回顾性研究,分析手术前后主侧弯角度变化、后凸角度变化、身高变化、手术并发症等。[结果]所有病例均顺利完成手术。共53次手术,平均每人3.4次。接受5次手术者4例,4次手术者2例,3次手术者5例,2次手术者5例。术前主侧凸Cobb角为(102.9±27.9)°(52°~145°),后凸Cobb角(89.2±49.2)°(20°~141°),身高(116.8±9.5)cm(98~132 cm)。终末融合后主侧凸Cobb角(36.4±14.2)°(21°~61°),终末侧凸矫形率64.4%。后凸Cobb角(39.0±9.8)°(31°~50°),终末后凸矫形率56.3%。身高(150.7±9.9)cm(132~165 cm),终末身高增加33.9 cm。围手术期发生内固定棒断裂4例次,内固定松动9例次,皮肤感染3例,一过性神经症状6例次,保守治疗均好转。[结论]后路小切口分期延长联合终末矫形融合术安全性好,终末矫形率高,保持身高增长,可以有效治疗小儿脊柱侧凸。
[Abstract]:[objective] to observe the clinical efficacy and safety of posterior small incision stage lengthening combined with end-orthopaedic internal fixation fusion in the treatment of childhood scoliosis. [methods] from March 2007 to May 2015, 16 cases of infantile scoliosis were accepted in our hospital. The small incision was extended by stages many times and the final orthopedic fusion operation was completed in all cases, among which 10 cases were congenital. There were 5 cases of early onset and 1 case of neurofibromatosis. The clinical data and imaging data of all cases were retrospectively studied, and the changes of main lateral curvature angle, kyphosis angle and height before and after operation were analyzed. Surgical complications, etc. [results] all cases were successfully operated. 53 operations were performed. The mean number of times per person was 3.4 times. 4 cases underwent 5 operations, 4 cases underwent 4 operations, 2 cases underwent 3 operations, 5 cases underwent 2 operations. The Cobb angle of main kyphosis was 102.9 卤27. 9 掳and 52 掳/ 145 掳before operation. The Cobb angle of kyphosis was 89.2 卤49. 2 掳20 掳141 掳, height 116.8 卤9. 5 cm ~ (98) / 98 ~ 132 cm ~ (-1). The end fusion of Cobb angle was 36.4 卤14. 2 掳and 61 掳. The correction rate of kyphosis was 64.4%. The Cobb angle of kyphosis was 39.0 卤9.8 掳and the final kyphosis rate was 56.3%. The height was 150.7 卤9.9 cm ~ (-1) 132cm ~ (165) cm ~ (-1), and the final height increased by 33.9 cm 路m ~ (-1). During the perioperative period, 4 cases of internal fixation rod fracture occurred. There were 9 cases of loosening of internal fixation, 3 cases of skin infection, 6 cases of transient neurological symptoms, all of which were improved by conservative treatment. [conclusion] posterior small incision stage prolongation combined with final orthopedic fusion is safe, the rate of terminal orthopedics is high, and the growth of height is maintained. It can effectively treat scoliosis in children.
【作者单位】：解放军306医院骨科全军脊柱外科中心;
【分类号】：R726.8

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