后路小切口分期延长技术与生长阀技术治疗早发型脊柱侧凸的临床比较研究

目的]观察小切口分期延长和生长阀两种不同术式治疗早发型小儿脊柱侧凸的临床疗效和安全性.方法]25例早发型小儿脊柱侧凸分别接受生长阀和小切口分期手术治疗.按手术术式分为两组:生长阀组和小切口组,对两组病例临床数据和影像学资料进行回顾性对照研究.结果]所有病例均顺利完成手术.生长阀组术前Cobb角为(92.0±16.4)°(72°～ 132°).终末融合后侧凸主侧凸冠状面Cobb角为(37.2±22.1)°(31°～64°),平均矫形率59.6％.小切口组术前Cobb角为(95.0±15.4)°(78°～135°),终末融合时术后侧凸主侧凸冠状面Cobb角为(31.8±6.6)°(27° ～48°),总矫形率为65.4％.两组均有并发症发生.结论]小切口分期延长技术或生长阀技术均可以治疗早发型小儿脊柱侧凸,小切口分期延长技术治疗较生长阀技术具有更高的矫形率,并发症发生率低,是值得推荐的治疗早发型小儿脊柱侧凸有效方法.

Comparative study of small incision technique and growth valve technique in the surgical treatment of early onset scoliosis

Objective]To observe the preliminary clinical results and safety of small incision minimally invasive surgery and growth valve technique in the treatment of early onset scoliosis(EOS).Methods]A retrospective control study was made on the clinical data and images of 25 EOS patients,they were divided into two groups by two different growing techniques.One was growth valve group and the other was small-incision technique group.Results]All patients underwent the procedures smoothly and no severe complications occurred.The major curve of small incision group before surgery were(92.0±16.4)°and(37.2±22.1)° after the final fusion surgery,the mean overall correction rate was 59.6%.The major curve of small incision group before surgery were(95.0±15.4)°and(31.8±6.6)°after the final fusion surgery,the mean overall correction rate was 65.4%.Conclusion]Both small incision and growth valve and surgery by stages in the treatment of early onset scoliosis are safe and the correction rate are good.Small incision technique is more likely to be recommended in the treatment of skeletally immature EOS patients.