中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (43): 8167-8170.doi: 10.3969/j.issn.1673-8225.2011.43.045

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    

脊柱后路截骨并三维矫形及3代椎弓根钉系统置入治疗休门氏病脊柱后凸畸形：同一机构7年9例资料回顾

李  晔，王以朋，仉建国，沈建雄，赵  宏，赵  宇   

  1. 北京协和医院骨科，北京市100005
  • 收稿日期:2011-04-17 修回日期:2011-07-22 出版日期:2011-10-22 发布日期:2011-10-22
  • 通讯作者: 王以朋，北京协和医院骨科，北京市100005 ypwang@medmail.com.cn
  • 作者简介:李晔★，男，1981年生，河北省涿州市人，汉族，2010年中国协和医科大学毕业，硕士，住院医师，主要从事脊柱和创伤骨科的研究。 18601043088@163.com

Posterior spinal osteotomy, three-dimensional orthopedic treatment and third-generation pedicle screw fixation system for treatment of Scheuermann's disease: A data review of 9 cases in the same organization within 7 years

Li Ye, Wang Yi-peng, Zhang Jian-guo, Shen Jian-xiong, Zhao Hong, Zhao Yu   

  1. Department of Orthopedics, Peking Union Medical College Hospital, Beijing  100730, China
  • Received:2011-04-17 Revised:2011-07-22 Online:2011-10-22 Published:2011-10-22
  • Contact: Wang Yi-peng, Department of Orthopedics, Peking Union Medical College Hospital, Beijing 100730, China ypwang@medmail.com.cn
  • About author:Li Ye★, Master, Physician, Department of Orthopedics, Peking Union Medical College Hospital, Beijing 100730, China 18601043088@163.com

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摘要：

背景：目前国内对休门氏病报道较少，缺乏相关临床经验。
目的：回顾性分析休门氏病脊柱后凸畸形的诊断、临床表现、手术方法以及术后早期疗效。
方法：选择2002-01/2009-12北京协和医院骨科收治的休门氏病脊柱后凸患者9例，均采用脊柱后路截骨并三维矫形治疗。评价治疗前后脊柱后凸矢状面Cobb角、矢状位颈7铅垂线与骶1后缘铅垂线距离以及临床症状的变化。
结果与结论：7例患者获得临床及影像学随访，随访时间3~88个月，失访2例。脊柱后凸内固定前Cobb角平均68°(30°~86°)，矢状位颈7铅垂线与骶1后缘铅垂线距离平均为4.5 cm；脊柱后凸内固定后Cobb角平均29°(0°~56°)，矫正率平均55%(35%~100%)，末次随访脊柱后凸Cobb角平均30°(5°~58°)，平均丢失1°，矢状位颈7铅垂线与骶1后缘铅垂线距离平均为1.5 cm，随访未发生明显丢失。全部随访病例均未发生神经损伤及其他并发症。经治疗后脊柱外形恢复正常或接近正常，局部无压痛。提示应用一期脊柱后路截骨配合三维矫形器械可以有效地矫正休门氏病脊柱后凸畸形，获得满意的脊柱矢状位力线，良好的植骨融合以及内固定后短时间佩戴支具有助于矫形效果的维持。

关键词: 休门氏病, 脊柱后凸, 一期脊柱后路截骨, 三维矫形, 椎弓根内固定

Abstract:

BACKGROUND: Currently, there are few reports about Scheuermann’s disease, and relevant clinical experiences are lack.
OBJECTIVE: To evaluate the clinical diagnosis, manifestation and operative treatment of Scheuermann’s kyphosis and analyze its clinical outcomes.
METHODS: Nine patients with Scheuermann’s disease were selected in the Department of Orthopedics, Peking Union Medical College Hospital, from January 2002 to December 2009. All the patients received posterior spinal osteotomy and three-dimensional orthopedic treatment. The kyphosis Cobb’s angle in the sagittal plane, clinical manifestation were evaluated both before and after operation.
RESULTS AND CONCLUSION: The median follow-up was 27 months (3-88months), and two cases were lost. The mean kyphosis Cobb’s angle in the sagittal plane changed from 68° (30°-86°) to 29° (0°-56°). The correction rate was about 55% (35%-100%). The kyphosis Cobb’s angle on the final follow-up was 30° (5°-58°), and the mean lost angle was 1°. The sagittal balance was good (from 4.5 cm to 1.5 cm). All patients, who had chronic back pain, fatiguability refractory to conservative treatment, improved considerably after surgery. One-stage posterior spinal osteotomy with three-dimensional orthopedic treatment can be used effectively for the correction of Scheuermann’s kyphosis.

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