CT三维重建在脊柱半椎体畸形矫正手术中的价值

目的　评价螺旋CT三维重建在先天性脊柱畸形矫正手术中的作用和价值。  方法　21例先天性半椎体脊柱畸形患者，术前采用螺旋CT扫描及三维重建，设计手术节段及切除范围，采用后路椎板、半椎体切除，全椎体切除，截骨及椎弓根钉棒系统内固定、或单纯前路骨骺阻滞，分析手术前后Cobb's角度数，评价术后临床疗效。  结果　平均手术时间为（151.43±22.20）min，平均术中出血量为（709.52±　359.03）ml。术前侧凸角度（81.81±25.06）°，术后侧凸角度（27.05±16.56）°，矫正率（69.85±13.33）%；术前后凸角度（77.29±28.10）°，术后后凸角度（29.38±19.55）°，矫正率（66.15±18.85）%。  结论　术前螺旋CT三维重建可以帮助设计手术方案，对手术操作有指导意义，缩短手术时间，减少术中出血量，提高手术疗效。

The effects of CT reconstruction on corrective procedure of hemivertebra deformity

Objective To evaluate the effect and value of spiral CT three-dimension reconstruction on the correction of spinal hemivertebra deformity.Methods A total of 21 cases with congenital hemivertebra deformity underwent spiral CT scan and three-dimensional reconstruction preoperatively,which was taken as the basis for surgery designation.Using techniques of posterior decompression hemivertebractomy or laminectomy,hemivertebra resection,pedicle screw fixation or anterior epiphyseal block were performed.And then the pre-and post-operative changes of Cobb’s angle were analyzed.Results Averagely,The operation time was(151.43±22.20) min,and blood loss(709.52±359.03) ml.The scoliosis Cobb’s angle was(81.81±25.06)° preoperatively,and(27.05±16.56)° postoperatively respectively,with the correction rate of(69.85±13.33) %.The kyphoscoliosis Cobb’s angle was(77.29±28.10)° and(29.38±19.55)° pre-and postoperatively,with the correction rate of(66.15±18.85)%.Conclusions The spiral CT scan and the followed three-dimensional reconstruction are helpful for individual designing and guiding of surgery program,shorting the operation time,decreasing blood loss,and improving the efficiency of the surgery.