单一后路“蛋壳”技术半椎体切除术治疗先天性脊柱侧凸

发布时间：2018-06-07 19:02

本文选题：先天性脊柱侧凸 + 半椎体畸形　；参考：《福建医科大学》2015年硕士论文

【摘要】：目的评价单一后路“蛋壳”技术半椎体切除术治疗完全分节型半椎体所致先天性脊柱侧凸的矫形效果、手术安全性和并发症等情况。方法回顾性分析2010年1月至2015年1月期间,于我院脊柱外科接受单一后路“蛋壳”技术半椎体切除术的先天性脊柱侧凸患者18例,其中男性11例,女性7例;手术时的平均年龄10.8岁(3-23岁)。所有患者的脊柱侧凸均由完全分节型半椎体畸形所致。测量并比较术前、术后以及随访时脊柱正侧位片上的侧凸Cobb角和后凸Cobb角,评估该术式的矫形效果。此外,还记录手术时间、术中出血量、术后并发症等情况。结果手术时长约155-270分钟,平均228分钟;术中出血量约为100-3000ml,平均出血量为850ml。手术固定融合节段2-5个,平均为3.3个节段。术后随访时间3-40个月,平均19个月。冠状面上的主侧凸Cobb角由术前的40.07°矫正至术后的18.57°,矫形率为53.93%;矢状面上的节段性后凸Cobb角由术前的22.73°矫正至术后的9.50°,矫形率为58.20%;末次随访时,主侧凸Cobb角的平均值为25.53°、节段性后凸Cobb角的平均值为14.57°,与术后相比,两者分别丢失了6.96°和5.07°。18例患者中,2例出现内固定相关并发症、1例发生手术切口感染。所有患者均未出现神经系统并发症。结论完全分节型半椎体所致先天性脊柱侧凸需要早期手术治疗。单一后路“蛋壳”技术半椎体切除术直接去除致畸原因,能有效矫正脊柱冠状面和矢状面上的畸形;并且,该术式并发症发生率低、安全性高,因此它是治疗先天性脊柱侧凸安全有效的手术方式。
[Abstract]:Objective to evaluate the orthopaedic effect, surgical safety and complications of single posterior eggshell hemivertebra resection in the treatment of congenital scoliosis caused by complete segmental hemivertebra. Methods from January 2010 to January 2015, 18 patients with congenital scoliosis underwent single posterior "eggshell" hemivertebra resection in our hospital, including 11 males and 7 females. The mean age at the time of operation was 10.8 years old and 3-23 years old. All patients with scoliosis were caused by complete segmental hemivertebra deformities. The preoperative, postoperative and follow-up Cobb angle of scoliosis was measured and compared with that of kyphosis angle. In addition, the operation time, intraoperative bleeding, postoperative complications were recorded. Results the operative time was 155-270 minutes with an average of 228 minutes, and the blood loss during operation was about 100-3000 ml, and the average bleeding volume was 850 ml. Two to five fusion segments were fixed, with an average of 3.3 segments. The follow-up time was 3-40 months (mean 19 months). The Cobb angle in the coronal plane was corrected from 40.07 掳preoperatively to 18.57 掳postoperatively, the correction rate was 53.93 掳, the correction rate of the segmental Cobb angle on the sagittal plane was 58.20 cm from 22.73 掳preoperatively to 9.50 掳postoperatively. The mean value of Cobb angle of principal scoliosis was 25.53 掳, and that of segmental kyphosis was 14.57 掳. Compared with postoperative, the two patients lost 6.96 掳and 5.07 掳.18 cases respectively, 2 cases had complications related to internal fixation and 1 case had operative incision infection. No neurological complications were found in all patients. Conclusion congenital scoliosis caused by complete segmental hemivertebrae needs early surgical treatment. The single posterior "eggshell" technique can remove the causes of teratogenicity directly, which can effectively correct the coronal and sagittal deformities of the spine, and has low incidence of complications and high safety. Therefore, it is a safe and effective surgical method for the treatment of congenital scoliosis.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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