重度脊柱侧凸的后路手术矫治

目的评价后路矫形内固定术治疗重度脊柱侧凸的疗效。方法重度脊柱侧凸患者16例，进行后路矫形内固定术治疗，术前主弯Cobb角71°-110°（84°±11°），其中矢状面异常患者11例。结果手术时间3．4—5．1（4．1±0．6）h，出血量570—1120（778±178）ml，平均融合节段11（9—13）个椎体，术后主弯Cobb角24°-44°（31°±5°），11例矢状面异常患者重新恢复了胸椎生理性后凸和腰椎生理性前凸，未发生感染、血气胸和神经系统等并发症。终末随访时，主弯Cobb角27°-45°（33°±5°），矫正丢失率为0—13％（7％±5％），固定范围内植骨全部融合，未发生术后失代偿和假关节形成。结论后路矫形内固定术是治疗重度脊柱侧凸安全有效的方法。

The operation of posterior correction and fixation for severe scoliosis

Objective To evaluate the clinical effect of orthopedic procedure with the operation of posterior correction and fixation for severe scoliosis. Methods 16 cases of severe scoliosis were treated by the posterior operation of correction and fixation. The preoperative Cobb angle of all cases was 71°- 110°（84° ± 11°） , and there were 11 cases with disequilibrium of the spine on sagittal plane. Results The operation time was 3.4 -5.1 （4. 1 ±0.6） h and the amount of blood loss was 570 - 1 120（778 ± 178） ml, the average level of instrumented vertebra was 11 （9 - 13） , and 11 patients with disequilibrium of the spine on sagittal plane, have restored normal thoracic kyphosis and normal lumbar lordosis. No infection, hemopneumothorax and nervous lesion were found. The Cobb angle of the major curves at the final fellow up was 27° -45°（33°±5°） ,and the loss of correction was 0 - 13% （7% ± 5% ）. Solid fusion was obtained in all patients and there were no incidence of decompensation and pseudoarticulation formation. Conclusions The operation of posterior correction and fixation is a safe and effective method in the treatment of severe scoliosis.