PUMCⅡd1型青少年特发性脊柱侧凸三维有限元模型的建立

背景：建立高质量的有限元模型是进行生物力学分析研究的重要基础,完整的青少年特发性脊柱侧凸三维有限元模型报道甚少。 目的：建立PUMCⅡd1型青少年特发性脊柱侧凸三维有限元模型,为特发性脊柱侧凸的生物力学分析提供有效的数字化平台。 方法：采集1 例14岁PUMCⅡd1型特发性脊柱侧凸女性志愿者从T1至骶尾骨的CT 断层图像,将CT数据导入Mimics 16.0医学三维重建软件中,建立包括胸廓结构的完整脊柱侧凸三维几何模型。再将几何模型以点云格式导入Geomagic Studio 11.0软件中,对三维模型进行光滑、打磨、去噪等一系列图像处理,生成特发性脊柱侧凸三维有限元模型。最后导入ANSYS 14.0有限元分析软件中添加韧带、设置单元类型和定义材料属性,生成完整的特发性脊柱侧凸三维有限元模型。 结果与结论：成功建立了完整的PUMCⅡd1型特发性脊柱侧凸三维有限元模型,包括四面体单元522 887个和杆单元730个,共计523 617个单元,159 008个节点。试验建立了外形逼真的PUMCⅡd1型特发性脊柱侧凸三维有限元模型,为进一步的生物力学分析提供了可靠的数字化模型。中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程全文链接：     

椎弓根螺钉固定局部减压与选择性椎间融合修复退变性腰椎侧凸

背景:对于严重的退变性腰椎侧凸所引起的腰背痛,保守治疗多数无效,一般需要外科干预手术治疗。修复方式多为对"责任椎"进行减压、坚强固定、选择性椎间植骨融合为主,重新建立腰椎正常曲度和脊柱的平衡及良好的稳定性。目的:探讨采用椎弓根螺钉固定局部减压与选择性椎间融合修复退变性腰椎侧凸的效果。方法:回顾性分析2011年1月至2014年1月武警湖南省总队医院收治的57例退变性腰椎侧凸患者,根据患者自身的临床特点,均采用选择性椎间融合、局部减压和椎弓根螺钉置入内固定的修复方案,以影像学分析及Suk标准评价固定、减压、植骨融合情况,日本骨科学会评分评价疗效优良率。结果与结论:(1)手术时间157-255 min,平均176 min;出血量480-1 700 mL,平均835 mL;术后引流量140-210 mL,平均155 mL;(2)57例患者获得12-38个月随访,术后X射线提示,治疗后冠状面Cobb’s角(3.8±2.1)°,侧凸矫正率为54%;治疗后矢状面Cobb’s角(6.3±10.5)°,前凸矫正率为35%。Suk标准评定椎间融合率为95%;根据日本骨科学会腰背痛评分评估末次随访时患者的疗效优良率为91%;(3)术中硬膜囊破裂引发脑脊液漏2例,神经损伤1例,椎弓根螺钉拔出失败1例,无感染,无血管损伤;(4)结果说明,结合患者影像学资料与自身临床特点,采用椎弓根螺钉固定局部减压与选择性椎间融合修复退变性腰椎侧凸,可使退变的侧凸腰椎在冠状面和矢状面上均得到不同程度的重建和稳定,修复效果满意。     

基于3D打印技术选择性椎弓根螺钉治疗青少年特发性脊柱侧凸

BACKGROUND: Three-dimensional (3D) printing has been popular for preoperative planning, and has been extensively used in bone tumor resection and pelvic fractures achieving satisfactory treatment outcomes. However, seldom used in adolescent idiopathic scoliosis.     

前路颈椎间盘切除和椎体次全切除植骨融合治疗临近两椎节脊髓型颈椎病

BACKGROUND: Anterior cervical discectomy and fusion with stand-alone cages and anterior cervical corpectomy and fusion with plate-mesh are widely used techniques in the treatment of cervical spondylotic myelopathy. There were less comparative studies about these two techniques in surgical treatment of two-level contiguous cervical spondylotic myelopathy patients based long-term follow-up.     

基于3D打印模型确定经椎弓根椎体截骨治疗脊柱后凸畸形的最佳选择

BACKGROUND: Three-dimensional (3D) printing for preoperative planning has been gaining popularity at present. 3D printing has been frequently used in bone tumor resection and pelvic fracture surgery, but seldom used in kyphosis deformity.     

双侧钉棒梯次紧凑闭合脊髓短缩联合植入物内固定矫正僵硬性脊柱角状后凸

背景：胸腰椎角状后凸手术的治疗难点在于矫正率低,矢状面重建难,易发生神经并发症,术后失平衡、假关节发生率高及术后矫正度丢失。 目的：探讨改良经后路全脊椎切除截骨端双侧钉棒梯次紧凑闭合脊髓逐步短缩联合植入物内固定治疗严重脊柱角状后凸畸形的安全性和有效性。 方法：选择2006年1月至2013年12月解放军第306医院骨科收治的严重脊柱角状后凸畸形患者87例,男36例,女51例,采用经后路全脊椎切除截骨、双侧钉棒联合梯次紧凑闭合脊髓逐步短缩、植入物内固定方法治疗,对患者治疗前、后的后凸角、脊柱矢状位失平衡、躯干侧方偏移率、手术时间及术中失血量进行观察分析。 结果与结论：患者治疗前的后凸角为31°-138°,平均90.1°;治疗后为15°-57°,平均27.9°,改善率为76%。躯干矢状位偏移的改善率为76%。术中失血量为800-3 000 mL,平均失血量为2 300 mL;手术时间为5-7 h,平均手术时间5.9 h;治疗前2例患者伴有双下肢神经症状,Frankel分型C级,治疗后恢复至E级。治疗后随访9-57个月,所有患者的截骨节段均获得骨性融合,无脊髓损伤并发症出现,无矫形角度丢失。提示经后路全脊椎切除截骨治疗重度僵硬性胸椎角状后凸畸形,术中可对血管最大限度的保留,避免血管损伤导致脊髓的缺血性改变以及缺血再灌注损伤等,低体质量患者手术过程中减少出血、以及保障有效血容量是治疗后早期恢复的有效保障;双侧钉棒联合梯次紧凑闭合脊髓逐步短缩脊柱矫形技术在胸腰椎角状后凸畸形的矫正过程中能够最大限度保护脊髓细胞不受损伤,应注意对神经根的保护和松解,避免术后出现相应的神经根刺激症状;充分的植骨融合程度是保证后凸畸形矫正、避免脊柱侧方偏移,同时又是脊柱功能和术后矫形效果的有效保障。中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程全文链接：中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程全文链接：     

经皮椎体后凸成形分次和温度梯度灌注骨水泥治疗胸腰椎转移性肿瘤

背景：经皮椎体后凸成形治疗已被广泛用于椎体骨质疏松性压缩性骨折,现在亦被用于治疗椎体转移性肿瘤。 目的：评估采用经皮椎体后凸成形分次和温度梯度灌注骨水泥治疗胸腰椎转移性肿瘤效果。 方法：回顾性分析经皮椎体后凸成形分次和温度梯度灌注骨水泥治疗胸腰椎转移性肿瘤病例共24例38椎,分为椎体压缩≥1/4组9例11椎和椎体压缩< 1/4组15例27椎。在C臂机透视定位下行经皮椎体后凸成形,采用分次灌注、温度梯度灌注方法注射骨水泥。以目测类比评分及Owestry功能障碍指数评估经皮椎体后凸成形分次和温度梯度灌注骨水泥治疗前后疼痛缓解情况,日常功能恢复情况,治疗椎的高度变化。随访时间为12-56个月。 结果与结论：24例患者均成功完成经皮椎体后凸成形分次和温度梯度灌注骨水泥治疗。平均单个胸椎内注射骨水泥(4±1) mL,单个腰椎内注射骨水泥(5±1) mL。治疗后复查X射线片见骨水泥分布良好,无神经根损伤或脊髓压迫症状。两组患者治疗后椎体高度显著高于治疗前(P < 0.05)。所有患者治疗后1 d、治疗后1个月及末次随访时目测类比评分、功能障碍指数值均显著低于治疗前(P < 0.05);两组相同时间点目测类比评分、功能障碍指数评分的改变值差异无显著性意义。结果表明经皮椎体后凸成形分次和温度梯度灌注骨水泥治疗胸腰椎转移性肿瘤,可减少骨水泥渗漏的发生,不论肿瘤转移椎体有无明显压缩,均能迅速缓解疼痛,是治疗椎体转移肿瘤的有效方法。中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程全文链接：     

后路截骨矫形螺钉置入内固定修复胸腰段僵硬性角状后凸畸形：中期随访评价

BACKGROUND: During spinal orthopedic repair, the main difficulty is to maximize the correction of the deformity, simultaneously, to reduce the incidence of trauma and complications, especially to avoid the corresponding spinal nerve injury.OBJECTIVE: To evaluate the curative effect of one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation in the treatment of rigid angular kyphosis of thoracolumbar spine.METHODS: We retrospectively analyzed the data of 42 cases of rigid angular kyphosis of thoracolumbar spine that were treated by one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation. All patients received detailed imaging examination before and after operation. Kyphosis angle, Frankel grading and perioperative complications were recorded in all patients. X-ray films or CT films showed the bone graft fusion during follow-up.RESULTS AND CONCLUSION:Patients were followed up for 10-36 months after treatment. The average time of bone graft fusion was 5.1 months. Cobb’s angle of kyphosis was corrected from 78.4° (38°-110°) preoperatively to 7°(-8°-24°) at 10 days after treatment. The correction rate was 90%. The average angle during final follow-up was 7.9°, with an average loss of 0.9°. In 16 paresis patients, Frankel grading results showed grade B in 0 case, grade C in 3 cases, grade D in 5 cases, and grade E in 8 cases during final follow-up, showing significant improvement as compared with that pre-treatment (P < 0.05). Among 42 patients, 5 cases had complications. At 7 months after treatment, there were screw and titanium rod loosening at the distal end of the fusion segment in 1 case, cerebrospinal fluid leakage in 2 cases, transient double lower limb weakness in 1 case, pain in one side of lower limb in 1 case, and no severe complications appeared. These results verified that one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation could achieve satisfactory clinical outcomes in rigid angular kyphosis of thoracolumbar spine. The internal fixation was stable and with a high fusion rate and few complications. The medium-term effect was satisfactory.  中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程     

数字化三维重建与传统经皮球囊扩张椎体后凸成形的随机对照比较

背景：术者的经验对经皮球囊扩张椎体后凸成形治疗的手术时间和修复效果有直接影响,数字化技术辅助为优化修复方案开辟了新的思路。 目的：比较数字化技术辅助与传统经皮球囊扩张椎体后凸成形治疗在手术时间和修复效果方面的差异。 方法：选择2013年1月1日至2014年11月20日江苏省淮安市第二人民医院骨科收治的经皮球囊扩张椎体后凸成形患者64例。采用随机对照的方法,根据入院先后顺序,单数行数字化技术辅助经皮球囊扩张椎体后凸成形治疗(试验组),偶数行传统经皮球囊扩张椎体后凸成形治疗(对照组)。对两组患者的发病年龄、治疗前目测类比评分、手术时间、治疗后3 d目测类比评分以及治疗前后目测类比评分下降值等指标进行对比分析。 结果与结论：经统计学分析数字化技术辅助与传统经皮球囊扩张椎体后凸成形治疗在手术时间、治疗后3 d目测类比评分和治疗前后目测类比下降值方面差异均有显著性意义(P < 0.05),试验组优于对照组。提示数字化技术辅助经皮球囊扩张椎体后凸成形治疗能明显缩短手术时间,优化修复方案,获得更加理想的修复效果,提高患者满意度。中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程     

Use of O-arm with neuronavigation in percutaneous vertebroplasty reduces the surgeon’s exposure to intraoperative radiation

IntroductionPercutaneous vertebroplasty is commonly used to treat spinal fractures. The authors compare radiation exposure as potential risk for the surgical team during vertebroplasty guided by O-arm combined with neuronavigation versus vertebroplasty guided by C-arm fluoroscopy.Material and methodsThe clinical material consisted of a group of 29 patients (44 vertebrae) with fractures of the thoracolumbar spine treated with percutaneous vertebroplasty guided by O-arm with neuronavigation. In this new method, the operating room staff leaves the operating room for the duration of the 3D scan of the appropriate spine section using the O-arm. In the next stage, the needle of the vertebroplasty system is introduced using only neuronavigation without the need for a radiological view. Finally, the cement injection was made under O-arm fluoroscopic control. The comparison group consisted of a group of 35 patients (40 vertebrae) treated with the classical method using C-arm fluoroscopy. The two methods were compared in terms of the average dose of emitted ionizing radiation through the device (O-arm vs. C-arm) to which surgeons are exposed during percutaneous vertebroplasty.ResultsAs a result of vertebroplasty procedures guided by neuronavigation, a statistically significant difference between the values of mean dose of radiation emitted by O-arm and C-arm systems was noted. The O-arm emitted 912 cGy/cm² vs. 1722 cGy/cm² emitted by the C-arm during fluoroscopically assisted procedures and 601.28 cGy/cm² vs. 1506.86 cGy/cm² per vertebrae.ConclusionsDuring vertebroplasty with the O-arm combined with neuronavigation the radiation dose is significantly lower as compared with the C-arm used for fluoroscopic guidance, minimizing the potential risk of radiation exposure to surgeons.     

儿童脊柱侧凸非融合手术治疗的发展及现状

背景：儿童脊柱侧凸的治疗是脊柱外科的挑战之一,外科手术治疗尚没有满意的方法。 目的：综述儿童脊柱侧凸外科治疗方法的发展及现状,分析各种方法的利弊,展望儿童脊柱侧凸非融合手术治疗的发展。 方法：以“Scoliosis,Infantile scoliosis,Juvenile scoliosis,fusionless surgery,spinal implant”为英文检索词,“脊柱侧凸,少儿型脊柱侧凸,青少年型脊柱侧凸,脊柱内固定器,脊柱侧凸非融合手术” 为中文检索词,检索Pubmed数据库、CNKI数据库2001至2012年发表的相关文献。共检索到113篇文献,排除无关重复的文献,保留36篇进行综述。 结果与结论：目前脊柱侧凸外科治疗主要方法中,撑开技术可以保证脊柱的生长但需要不断的后期延长,生长导向技术可以避免不断的延长手术,但脊柱的生长不能得到保证,也不能纠正脊柱的旋转畸形;而生长调节技术对脊柱畸形的纠正有一定的作用,但它对严重脊柱畸形的作用是不确定的;可生长三维矫形技术的动物实验证明既能保证脊柱的生长,同时能纠正脊柱的旋转,术后不需要不断地延长,理论上是较理想的治疗方法,需要临床研究验证。     

CT影像处理技术在脊柱畸形矫形手术设计中的应用价值

目的探讨CT影像处理技术在脊柱畸形矫形手术设计中的应用价值。方法 30例脊柱畸形矫形患者同期行X线片、CT检查,其中CT检查图像处理主要为3D骨重建和3D重建加CTA联合成像。结果 X线平片无法进行动态旋转观察,并且椎管内结构情况不满意。CTA联合成像和3D骨重建在脊柱侧弯的椎体显示方面效果均优于X线平片,重建图像可以旋转任意角度,切除干扰肋骨,从而可以发现脊柱三维空间的畸形。在CT测量的值中,骨桥的CT值最大,正常椎体的CT值最少,各个组织间的CT值多存在显著差异（P〈0.05）。结论 CT影像处理技术在脊柱畸形矫形手术中的应用能在侧弯椎体确认、椎体旋转度测量和椎管显示方面获得很好的效果,同时不同骨组织的CT值也明显不同,从而为手术设计提供了参考。     

Posterior-only spinal fusion without rib head resection for treating type I neurofibromatosis with intra-canal rib head dislocation

OBJECTIVES:

Patients with Type I neurofibromatosis scoliosis with intra-canal rib head protrusion are extremely rare. Current knowledge regarding the diagnosis and treatment for this situation are insufficient. The purpose of this study is to share our experience in the diagnosis and surgical treatments for such unique deformities.

METHODS:

Six patients with Type I neurofibromatosis scoliosis with rib head dislocation into the spinal canal were diagnosed at our institution. Posterior instrumentation and spinal fusion without intra-canal rib head resection via a posterior-only approach was performed for deformity correction and rib head extraction. The efficacy and outcomes of the surgery were evaluated by measurements before, immediately and 24 months after the surgery using the following parameters: coronal spinal Cobb angle, apex rotation and kyphosis of the spine and the intra-canal rib head position. Post-operative complications, surgery time and blood loss were also evaluated.

RESULTS:

Patients were followed up for at least 24 months post-operatively. The three dimensional spinal deformity was significantly improved and the intra-canal rib head was significantly extracted from the canal immediately after the surgery. At follow-up 24 months after surgery, solid fusions were achieved along the fusion segments, and the deformity corrections and rib head positions were well maintained. There were no surgery-related complications any time after the surgery.

CONCLUSIONS:

Systematic examinations are needed to identify patients with Type I neurofibromatosis scoliosis with rib head dislocation into the canal who can be treated by posterior-only spinal fusion without rib head resection.     

O-arm导航辅助下后路半椎体切除治疗先天性脊柱侧后凸畸形

目的 探讨术中O-arm导航辅助下后路半椎体切除治疗半椎体所致先天性脊柱侧后凸畸形的应用价值。方法 回顾性分析河北医科大学第三医院脊柱外科2014年1月—2015年3月收治的14例半椎体所致先天性脊柱侧后凸畸形患者的临床资料,其中男5例、女9例,年龄9～15岁。患者均为单发性完全分节半椎体畸形,其中半椎体位于T₉ 1例、T₁₀ 2例、T₁₁ 5例、T₁₂ 3例、L₁ 2例、L₂ 1例。患者术前均拍摄站立位全脊柱正、侧位X线片,测量冠状面及矢状面Cobb角。在O-arm导航辅助下植入椎弓根螺钉,术中O-arm导航3D重建半椎体畸形,明确半椎体切除范围,彻底切除半椎体畸形。术中经O-arm扫描、术后经CT扫描观察螺钉位置;分析手术前后Cobb角,评价脊柱侧凸、后凸矫正率。结果 14例患者共置入椎弓根螺钉120枚,其中11例置入4对椎弓根螺钉,2例置入5对,1例置入6对;经术中O-arm扫描确认位置良好,术后CT扫描评估螺钉置入准确性:0级118枚(98.3%),1级2枚(1.7%)。本组病例手术时间平均为(195.4±17.4)min,术中出血量平均为(611.9±173.0)mL,术后随访3~15个月,平均9.6个月。术前侧凸Cobb角为62.8°±15.8°,术后为10.9°±5.3°,矫正率为83.34%±6.08%,末次随访时为12.1°±4.8°;术前后凸Cobb角为57.5°±15.5°,术后为17.0°±6.6°,矫正率为70.66%±6.79%,末次随访时为17.9°±7.0°。随访期间未见明显角度丢失。术后与末次随访时侧凸、后凸角度与术前比较,差异均有统计学意义(P值均<0.01);而术后与末次随访时比较,差异均无统计学意义(P值均>0.05)。本组病例术后无神经并发症,未发生螺钉松动、脱出、折断等。结论 在后路半椎体切除治疗先天性脊柱侧后凸畸形的手术中,O-arm导航能够指导椎弓根螺钉的准确置入和半椎体的精准切除,减少手术并发症,提高手术安全性。     

后路椎体环截及钛合金钉棒内固定治疗重度脊柱畸形

背景：椎体环截是近年来提出较多的脊柱矫形概念,因其操作技巧要求高,难度大,并发症多,既往相关文献报道角度各不相同,很多研究者注重并发症分析,究其原因与操作步骤及方式有关。 目的：分析单纯后路椎体环截及螺钉置入治疗重度脊柱畸形的疗效和并发症。 方法：回顾性分析48例单纯后路椎体环截及螺钉置入治疗重度脊柱畸形患者的临床资料,平均切除椎体1.6个,随访15-64个月,分析所有患者治疗前、治疗后及最后一次随访时Cobb角(冠状面及矢状面),并对手术相关并发症进行分析。 结果与结论：纳入的脊柱畸形患者共分5类,其中脊柱侧后凸畸形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。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°。手术时间平均545 min(204-1 355 min),术中平均估计失血量 1 610 mL(50-8 244 mL),平均失血量达65%。31例治疗后出现并发症,其中13例术中神经功能异常(通过电生理监测及唤醒实验发现),及时处理后患者未出现永久性神经功能障碍。提示单纯后路椎体环截及螺钉置入治疗重度脊柱畸形效果良好,但并发症高,操作难度较大。     

Segmental pedicle screw fixation for a scoliosis patient with post-laminectomy and post-irradiation thoracic kyphoscoliosis of spinal astrocytoma

Spinal deformity is an important clinical manifestation after surgery for spinal cord tumors. One-third of patients who receive laminectomies and irradiation of the spinal column develop scoliosis, kyphosis, or kyphoscoliosis. Recent reports indicate good results after scoliosis surgery using segmental pedicle screws and a navigation system, but these reported studies have not included surgery for post-laminectomy kyphosis. Hooks and wires are ineffective in such patients who undergo laminectomy, and there are also high perioperative risks with insertion of pedicle screws because landmarks have been lost. Here, we report on the 5-year follow-up of a 13-year-old male patient with post-laminectomy and post-irradiation thoracic kyphoscoliosis after surgical treatment of spinal astrocytoma. Posterior segmental pedicle screw fixation was performed safely using a computer-assisted technique. The authors present the first case report for treatment of this condition using a navigation system.     

数字化导航模板在脊柱畸形矫正术中的应用效果

目的 研究数字化导航模板在脊柱畸形矫正术中的临床应用。方法 选择2016年5月~2018年5月在我院拟行手术治疗的脊柱畸形患者40例,随机分为观察组与对照组,各20例。对照组用椎弓根钉内固定法进行矫形,观察组先进行个性化数字导航模板设计,完成术前规划及虚拟手术,再采用椎弓根钉内固定法矫形。比较两组手术时间、术中出血量、Cobb角矫正率及术后并发症发生率。结果 观察组Cobb角矫正率为84.20%,高于对照组的70.07%,差异有统计学意义（P＜0.05）;观察组手术时间、术中出血量少于对照组,差异有统计学意义（P＜0.05）;观察组术后并发症发生率低于对照组（0 vs 50.00%）,差异有统计学意义（P＜0.05）。结论 数字化导航模板应用于脊柱畸形矫正术中效果确切,可有效提高Cobb角的矫正率,减少手术时间以及术中出血量,降低并发症的发生。     

一期前后联合入路治疗胸腰段脊柱结核

目的探讨前路一期结核病灶清除植骨融合联合后路钉棒系统内固定治疗胸腰段椎体结核的疗效。方法 2007年2月～2009年10月手术治疗胸腰段椎体结核13例,均采用前路一期结核病灶清除取自体髂骨植骨融合联合后路钉棒系统内固定治疗胸腰段椎体结核,根据术前、术后X线平片分析植骨融合及术后畸形矫正效果。结果经6～18个月随访,脊髓神经功能得到不同程度的恢复,植骨融合满意,无内固定失败和脊柱结核病灶复发。结论前路一期结核病灶清除植骨融合联合后路钉棒系统内固定治疗胸腰段椎体结核具有椎管减压彻底,脊柱后凸侧弯畸形易于矫正,内固定远离病灶处等特点,是治疗胸腰段椎体结核的一种有效手术治疗方法。其缺点是手术创伤相对较大[1],术中操作相对繁琐。     

儿童先天性脊柱侧弯诊疗现状的临床研究

先天性脊柱侧弯是先天性椎体发育异常形成的三维空间的脊柱畸形,脊柱畸形往往进展迅速,如不早期积极干预,可能 导致脊髓受压,影响心肺发育,危害患儿身心健康遥早期诊断尧早期手术治疗可以有效减缓脊柱侧弯进展遥根据患儿自身情况可 以选择骨骺阻滞术尧生长棒技术和半椎体切除术等遥儿童脊柱侧弯矫治手术难度高,术前CT 三维重建可以很好地帮助外科医 生设计手术方式,降低术中并发症的发生率遥