牵拉成骨技术在发育期间脊柱畸形中的应用

[目的]探讨牵拉成骨技术在发育期间脊柱畸形中的应用价值。针对发育期间的脊柱弯曲畸形、侏儒症性脊柱发育障碍或合并有胸廓畸形、骨盆倾斜的病例，均可采用牵拉成骨技术达到治疗目的。[方法]根据头盆环牵引装置的原理，制成头环和盆环。头环用4钉法固定，盆环用2针法固定。另外用4根立柱连接头环与盆环，采用逐日升高的方法，使脊柱逐渐延长伸直，对弯曲畸形的脊柱产生三维矫正的作用。[结果]本组10例患者采用此法治疗，经过70～120d的牵拉过程，使脊柱畸形产生自家矫正功能，楔形椎体在牵拉的作用下恢复方形，使弯曲的脊柱伸直，旋转的椎体复位，达到三维矫正的目的。[结论]牵拉成骨技术在发育期间脊柱畸形中的应用，是一种代替脊柱内固定手术的微创技术。

Application of distraction osteogenesis in correction of deformity of spine during development

[ Objective ] To evaluate the value of distraction osteogenesis for treatment of deformity of spine during development. Distraction osteogenesis could be used for patients with campylorrhachia, dwarfism eccyliosis of spine or those combined with thoracocyllosis and obliquity pelvis. [ Method] According to the principle of Halo-pelvic distraction apparatus which was divided into two parts of halo and pelvic, the halo was 4-nail fixation and the pelvic was 2-nail fixation. The halo and pelvic were connected by 4 standing pillar. Through the daily extending of 4 standing pillar the curved spine was extended and stretched graduaUy. As a result, action of 3D correction of deformity of spine was achieved. [ Result] Ten patients of this group were treated by this methods. The action of 3D correction and automatic correction of deformity were showed in 70 - 120 days distraction that the wedge-shaped vertebra changed into squareness, curved spine was stretched and rotatory vertebra was reduced. [ Conclusion ] Distraction osteogenesis is a minimally invasive surgery instead of internal fixation of spine for the treatment of deformity of spine during development.