中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (52): 9859-9862.doi: 10.3969/j.issn.1673-8225.2011.52.039

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

椎弓根钉置入并后路半椎体切除修复胸腰椎半椎体畸形前后Cobb角的变化

姜  宇，朱国兴，杨玉生   

  1. 无锡市第二人民医院骨科，江苏省无锡市  214002
  • 收稿日期:2011-09-15 修回日期:2011-09-27 出版日期:2011-12-24 发布日期:2011-12-24
  • 作者简介:姜宇★，男，1983年生，江苏省无锡市人，汉族，2009年苏州大学毕业，硕士，医师，主要从事脊柱矫形外科的研究。 jiangyu314@sohu.com
  • 基金资助:

    无锡市医院管理中心2010年度医学科技发展资助项目(编号：YGM1009)。

Cobb angle changes in hemivertebra malformation patients before and after pedicle screw implantation combined with posterior hemivertebra resection

Jiang Yu, Zhu Guo-xing, Yang Yu-sheng   

  1. Department of Orthopedics, the Second People’s Hospital of Wuxi, Wuxi  214002, Jiangsu Province, China
  • Received:2011-09-15 Revised:2011-09-27 Online:2011-12-24 Published:2011-12-24
  • About author:Jiang Yu★, Master, Physician, Department of Orthopedics, the Second People’s Hospital of Wuxi, Wuxi 214002, Jiangsu Province, China jiangyu314@sohu.com
  • Supported by:

    Medical Science and Technology Development Project of Wuxi Hospital Management Center in 2010, No. YGM1009*

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280

被引次数

1

摘要：

背景：半椎体畸形是先天性脊柱侧后凸最常见的原因，半椎体切除可以直接去除致畸因素，是较理想的治疗方法。
目的：观察和评价经后路Ⅰ期半椎体切除，并椎弓根钉置入内固定治疗胸腰椎体半椎体畸形引起的前后Cobb角的变化，来评价治疗脊柱侧后凸畸形的效果。
方法：纳入2008/2010在无锡市第二人民医院骨科住院的11例由单个半椎体引起侧后凸畸形的青少年患者，均经Ⅰ期后路半椎体切除及椎弓根钉内固定修复。
结果与结论：患者随访1.0~2.0年，术后站立位全脊柱正侧位X射线片示冠状面Cobb角由修复前的(49.2±12.8)°改善至(16.5±5.8)°，平均矫正率达66.5%，矢状面Cobb角由修复前的(35.7±6.2)°改善至(14.1±1.9)°，平均矫正率达60.5%。终末随访时冠状面Cobb角(19.0±5.8)°，丢失2.8°；矢状面Cobb角(14.4±1.9)°，无明显丢失。且在随访过程中未发生神经系统损伤、感染及内固定失败等并发症。说明经后路Ⅰ期半椎体切除，椎弓根钉内固定修复半椎体畸形所引起的脊柱侧后凸畸形矫形效果满意，丢失率低，融合良好。

关键词: 先天性侧后凸, 畸形, 后路半椎体切除, 椎弓根钉固定, Cobb角

Abstract:

BACKGROUND: Hemivertebra malformation is the most common cause of congenital kyphoscoliosis. Hemivertebra resection can directly remove teratogenic factors, which is an ideal treatment method.                         
OBJECTIVE: To observe the Cobb angle changes before and after posterior hemivertebra resection and pedicle screw internal fixation for the treatment of hemivertebra malformation so as to evaluate the treatment effect on kyphoscoliosis malformation.
METHODS: Eleven adolescent patients with kyphoscoliosis malformation caused by single hemivertebra selected from the Department of Orthopaedics, the Second People’s Hospital of Wuxi between 2008 and 2011 were treated with posterior hemivertebral resection and pedicle screw internal fixation.
RESULTS AND CONCLUTION: During 1-2 years follow-up, posterior-anterior and lateral X-ray images showed that coronal planes Cobb angle in standing position was (49.2±12.8)° before treatment and corrected to (16.5±5.8)° after repairment (average correction rate of 66.5%); sagittal planes Cobb angle was (35.7±6.2)° before treatment and corrected to (14.1±1.9)° (average correction rate of 60.5%). At the final follow-up, the coronal planes Cobb angle was (19.0±5.8)° , and lost 2.8° and sagittal planes Cobb angle was (14.1±1.9)° without significant loss. During the follow-up, no complications of neurological damage, infection and implant failure occurred. It is indicated that the effect of posterior hemivertebra resection and pedicle screw internal fixation for the treatment of kyphoscoliosis malformation caused by hemivertebra malformation is satisfactory with a lower loss probability and successful fusion.

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