Chinese Journal of Tissue Engineering Research
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Kahaer•Aikenmu1, Chu Ge1, Huang Jia2, Gao Qi-le2, Wu Jia-wen2, Lin Min-zhong2
Received:
2013-06-24
Revised:
2013-07-11
Online:
2013-10-22
Published:
2013-11-02
Contact:
Chu Ge, Attending physician, Studying for doctorate, First Team of Department of Spine Surgery, Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
xiaochu138@sina.com
About author:
Kahaer?Aikenmu★, Master, Attending physician, First Team of Department of Spine Surgery, Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
330659692@qq.com
CLC Number:
Kahaer•Aikenmu, Chu Ge, Huang Jia, Gao Qi-le, Wu Jia-wen, Lin Min-zhong. Posterior vertebral column resections combined with titanium screw rod fixation for the treatment of severe spinal deformity[J]. Chinese Journal of Tissue Engineering Research, doi: 10.3969/j.issn.2095-4344.2013.43.006.
2.3 影像学分析结果 所有患者治疗前平均冠状面畸形角度由84°矫正到35°,总的矫正率达到54%。治疗前平均矢状面畸形角度由90°矫正到42°,矢状面 Cobb 平均减小了48°。 48例患者中脊柱侧后凸畸形11例,重度侧凸畸形20例,先天性脊柱畸形4例,球状后凸畸形3例,角状后凸畸形10例,收集所有患者治疗前、治疗后平均直立、屈曲位下Cobb角度数值(矫正率及平均后凸角度减小度数)。 对于重度侧弯的患者冠状面侧弯Cobb角在侧曲位片上由 104°减小为78°,治疗后首次拍片冠状面平均Cobb角为32°,最后一次随访为33°,平均矫正率为67%。 对于球面畸形的患者治疗前平均最大矢状面后凸Cobb角度101°,治疗前过伸位为79°,治疗后首次平均矢状面Cobb角46°,最后一次随访为47°,平均后凸角减小54°。 对于角状后凸畸形患者,治疗前平均最大矢状面Cobb角88°,屈伸位片几乎没改善,治疗后首次拍片矫正到39°,最后一次随访为38°,后凸角平均减小50°。 对于侧后凸患者,治疗前冠状面平均Cobb角为91°,侧曲位片减小为65°,治疗后首次平均冠状面Cobb角43°,最近一次随访平均Cobb角为44°,冠状位平均矫形率达51%;治疗前矢状面平均Cobb角104°,治疗后平均首次47°,最后一次随访无变化,后凸角度平均减小57°。 对于先天性脊柱畸形患者,治疗前冠状面平均Cobb角度47°,治疗后首次拍片显示治疗后平均矫正到22°,最后一次无变化,矫形率为46%;治疗前平均矢状面Cobb角56°,治疗后首次为30°,最后一次随访为32°,后凸角减小了24°。 2.4 并发症 见表2。"
共有31例患者出现并发症,最常见的术中并发症是术中神经电生理监测异常,结合唤醒实验提示急性脊髓神经损伤,其次最常见的术中并发症为术中估计失血量多于2 L,最常见治疗后早期并发症为呼吸系统相关并发症,包括肺部感染、重度肺不张、胸腔积液和切口感染。治疗过程中及治疗后无患者死亡。 2.5 SRS-22评分结果 所有患者治疗前及治疗后1年内应用SRS-30评分量表评价疗效,治疗前平均为3.6 (2.4-4.5)分,术后平均4.2(2.5-4.7)分,差异有非常显著性意义(P < 0.001)。 疼痛评分改善由4.0分到4.3分(P=0.136),外观自我评价从2.8分改善到4.2分(P < 0.001),功能改善从3.8分到4.1分(P=0.023),精神心理状态从3.8分改善到4.1分(P=0.035),满意度改善从3.0分改善4.3分(P < 0.001),所有患者治疗后评分均较治疗前明显改善。 2.6 典型病例 见图1,2。"
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