后路脊椎V型截骨术治疗创伤性脊柱后凸畸形

目的总结应用椎弓根钉-棒系统后路脊椎V型截骨术治疗创伤性脊柱后凸畸形的临床经验、技术要点及效果。方法将创伤性脊柱后凸畸形的病人分为两组，进行对比分析。治疗组：应用椎弓根钉-棒系统后路V型截骨内固定术29例；对照组：应用前路椎体骨折复位内固定融合术26例。结果与对照组相比，治疗组术后畸形复发率显著低于对照组（P〈0．05），断钉、松动等并发症发生率显著低于对照组（P〈0．05），骨折不融合、纠正后凸畸形度数对比无显著性差异（P〉0．05）。结论应用椎弓根钉-棒系统后路V型截骨术治疗的创伤性脊柱后凸畸形可有效防止手术后畸形再发生，矫正后凸畸形彻底、安全、可靠。

Study of the Treatment of Post-trauma Spinal Kyphotic Deformity with Posterior Wedge-shaped Excision and Fixation with Pedicle Screw-rod System

ObjectiveTo sum up the experience, technique and the initial clinical and radiographic results for the treatment of kyphosis of spine after trauma with posterior wedge-shaped excision and fixation with pedicle screw-rod system. MethodsAfter summarizing the background data. The control group(26 cases) with fixation by other methods, for example,vertebrae body-blast, short segmental unite of spinal fixation and bone grafting fusion, and the treating group(29 cases treated from Jan. 2000 to Jan. 2004) using with pedicle screw-rod system fixation are compared. ResultsTwenty-nine patients underwent this procedure. There is significant difference between control group and treating group in kyphosis recurrence rate(P<0.05). No significant difference was found about the nonunion between the control group and treating group(P>0.05), although the nonunion rate of treating group is bigger than the control group. There is significant difference between kyphosis rate of control group and treating group in Cobb-angle losing degree, screw-lose or fracture,and rod-fracture after surgery(P<0.05). ConclusionThe treatment and prevention of kyphosis of spine after trauma with posterior wedge-shaped excision and fixation with pedicle screw-rod system seems to be a reliable,safe, effective and simple technique, and should be considered as an efficient alternative to the previously reported techniques.