半椎体切除术治疗先天性脊柱侧后弯畸形

目的分析一期后路半椎体切除治疗先天性脊柱侧后凸畸形的手术效果,并探讨手术固定融合节段方案的选择。方法回顾分析15例由半椎体引起侧后凸畸形的患儿,其中男9例,女6例,年龄3～17岁,平均13.5岁。均行后路半椎体切除、矫形内固定及情骨融合手术。结果随访15～68个月,平均40.5个月。术后矫形效果满意,侧凸畸形由术前平均45.3°改善至11.4°（矫正率达68.7%）;后凸畸形由术前的平均35.5°,矫正至11.4°（矫形率达67.9%）,远期矫形丢失率低,植骨融合良好,无内固定物断裂松动等并发症。结论一期后路半椎体切除、椎弓根钉棒系统矫形内固定和植骨融合手术,可以有效矫正青少年脊柱结构性侧后凸畸形。

Hemivertebra Resection for Congenital Scoliosis and Kyphoscoliosis

Objective To assess the clinical result of hemivertebra resection by one stage posterior operation .for congenital scoliosis and kyphosis in children,and to confer the choice program of surgical fixation and fusion seg-ments. Methods Fifteen patients of congenital scoliosis and kyphosis caused by hemivertebra were retrospectively in- vestigated. All the patients underwent posterior approach treatment of hemivertebra resection,orthopaedic internal fixation and bone grafting fusion. Results 15 cases were all followed up for 15 to 68months （40. 5 months on average）. Postoperative clinical effect were satisfactory,the cobb angle of scoliosis was corrected from 45.3° to 11.4°after the operation（correction rate was 68.7%）,The cobb angle of kyphosis was corrected from preoperative 35.5°to postoperative 11.4°（correction rate was 67.9%）. Long-term correction loss rate was low and bone graft fusion was fine,and the internal fixations were not loosen or fractured, There were no other complications. Conclusion One stage posterior surgery of hemivertebral resection and pedicole screw-rod system and bone grafting fusion is an effec tive ooeration schemo to correct congenital scoliosis and kyphosis.