椎弓根螺钉固定在脊柱侧凸治疗中的应用

目的　探讨椎弓根螺钉固定在脊柱侧凸治疗中的应用效果。方法　采用连续或间断椎弓根螺钉固定技术治疗 93例脊柱侧凸患者 ,平均年龄 14 .3岁 ,特发性 5 1例 ,先天性 4 2例 ,术前Cobb角分别为 71.2°和 6 8.3° ,根据畸形程度和脊柱柔韧性 ,采用一次性矫形或分期矫形。结果　特发性侧凸术后Cobb角和矫正率分别为 2 8.7°和 6 1.5 % ,先天性侧凸为 32 .6°和 5 3.8% ,无严重并发症发生。结论　椎弓根螺钉固定对脊柱产生撑开、加压及旋转矫正作用 ,其矫正力大 ;且不占据椎管空间。尽管胸椎椎弓根螺钉固定难度较大 ,风险较高 ,但因其能对脊柱产生撑开、加压及旋转矫正作用 ,矫正力大 ,且不占据椎管空间 ,因此在具备一定技术条件时 ,该方法应被推广应用

The application of pedicle screw fixation for the treatment of scoliosis

Objective To present the effects of using the technique of pedicle screw fixation for the treatment of scoliosis.Methods 93 patients with the average age of 14.3 years, who were involving with the scoliosis and got treatment by using the technique of pedicle screw fixation continuously or discontinuously. Two groups were divided for comparative study that they were the idiopatic scoliosis group including 51 patients and the congenital scoliosis group including 42 patients. The average curve for the patients in these two groups before the operation were 71.2°and 68.3°respectively. The treatments were performing at one stage or several stages depending on the degree of deformity and spinal flexibility. Results The average postoperative curve and the corrective rate for the patients in the idiopatic scoliosis group was 28.7°and 61.5% respectively; and for those in the congenital scoliosis group was 32.6°and 53.8% respectively. There were no serious complications occurred.Conclusion The pedicle instrument may perform more functions including traction, compression and rotation; as a result, it can correct the deformity of spinal scoliosis maximally and does not occupy the cord space. However, concerning the difficulty of operating pedicle screw technique and the potential dangerousness of damaging the thorax, it is strongly suggesting to operate the instruments by the skillful surgeon. In some cases, the pedicle hook may be in substitution for the screw if necessary.