生长棒治疗1型神经纤维瘤病早发性脊柱侧凸

发布时间：2019-07-06 20:22

【摘要】：目的:观察生长棒治疗1型神经纤维瘤病早发性脊柱侧凸的有效性。方法:回顾性分析13例生长棒治疗的1型神经纤维瘤病早发性脊柱侧凸患者的临床资料,其中男8例,女5例;年龄5~10岁(7.5±2.1岁)。随访时间2~10年(5.1±2.8年)。生长棒置入术后每6个月撑开1次。影像学测量指标包括侧凸Cobb角、后凸角、躯干高度(T1~S1),并统计手术并发症。结果:术前侧凸Cobb角69.0°±21.2°(43°~90°),末次随访25.3°±15.0°(12°~45°),矫正率63.3%。躯干高度术前323.0±29.1mm(288~355mm),末次随访400.5±25.7mm(361~430mm),躯干高度增加77.1±18.3mm,每年继续生长11.7±3.3mm。9例患者出现并发症,并发症发生率69.2%。共发生并发症16例次,包括内置物失败9例次(56.3%),交界区后凸5例次(31.3%),内置物外露1例次(6.2%),深部感染1例次(6.2%)。9例后凸角50°患者中6例(66.7%)出现并发症,4例后凸角≥50°患者中3例(75%)出现并发症,两组并发症发生率差异无统计学意义(χ~2=0.123,P=0.726)。结论:生长棒治疗1型神经纤维瘤病早发性脊柱侧凸可有效改善脊柱畸形,并且保持躯干的继续生长;伴有严重后凸并未增加术后并发症的发生率。
[Abstract]:Objective: to observe the efficacy of growth rod in the treatment of type 1 neurofibromatosis with early onset scoliosis. Methods: the clinical data of 13 patients with type 1 neurofibromatosis with early onset scoliosis treated with growth rod were analyzed retrospectively, including 8 males and 5 females, aged 5 卤10 years (7.5 卤2.1 years). The follow-up time was 2 to 10 years (5.1 卤2.8 years). The growth rod was opened every 6 months after implantation. Imaging measurements included scoliosis Cobb angle, kyphosis angle, trunk height (T1~S1), and surgical complications were counted. Results: the Cobb angle of scoliosis was 69.0 掳卤21.2 掳(43 掳~ 90 掳) and the last follow-up was 25.3 掳卤15.0 掳(12 掳~ 45 掳). The correction rate was 63.3%. The height of trunk was 323.0 卤29.1mm (288~355mm) before operation and 400.5 卤25.7mm (361~430mm) at the last follow-up. The height of trunk increased by 77.1 卤18.3mm. Complications occurred in 11.7 卤3.3mm.9 patients. The incidence of complications was 69.2%. Complications occurred in 16 cases, including 9 cases of built-in failure (56.3%), 5 cases of kyphosis in junction area (31.3%), 1 case of internal exposure (6.2%) and 1 case of deep infection (6.2%). Complications occurred in 6 cases (66.7%) of 9 patients with kyphosis angle 50 掳and 3 cases (75%) of 4 patients with kyphosis angle 鈮，

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