选择性前路和后路手术治疗胸腰段或腰段脊柱侧凸的疗效分析

目的 比较选择性前路和后路手术治疗胸腰段或腰段青少年特发性脊柱侧凸的疗效.方法 1998年3月～2004年9月,共64例胸腰段或腰段特发性脊柱侧凸患者接受手术,其中36例采用选择性前路手术(A组),28例采用选择性后路手术(B组),随访时间为2～4 年.结果 A组术前胸腰段或腰段弯曲角度平均 42°,术后平均 18°;B组术前平均46°,术后平均18°.2 组患者术后弯曲都得到了明显改善,且2组患者改善率差异无统计学意义(P>0.05),术中的出血量差异也无统计学意义(P>0.05),而B组手术时间(179 min)

Analysis of selective anterior fusion versus posterior fusion of thoracolumber/lumber curves in adolescent idiopathic scoliosis

Objective To compare the results of anterior fusion versus posterior fusion of thoracolumber/lumber curves in adolescent idiopathic scoliosis. Method A total of 64 cases with thoracolumbar or lumbar scoliosis who had surgery from March 1998 to September 2004 were selected for this retrospective study. All had a minimum of 2 years follow-up (2-4 years). Result Cobb angle was corrected from 42° to 18° in group A and from 46° to 18° in group B. Both the two groups got a better correction of the curves. There were no significant differences between the two groups in percentage correction and estimated blood loss. Time of surgery was significantly shorter in group B (179 minutes vs. 279 minutes). Fusion levels were longer in group B (5.8 vs. 3.9). No complications were encountered in both groups at the latest follow-up. The incidence of proximal junctional kyphosis was higher in group B (P<0.01). Conclusion Both the two surgical treatments can be conducted in correcting thoracolumbar and lumbar adolescent idiopathic scoliosis. But the length of surgery was significantly shorter in the posterior group, and fusion levels were longer, the incidence of proximal junctional kyphosis was higher.