楔形三柱截骨术联合短节段椎弓根内固定系统治疗脊柱后凸畸形

目的:探讨治疗各种原因引起的脊柱后凸畸形的有效治疗方法。方法:采用后路楔形三柱截骨联合AF内固定系统手术治疗14例脊柱后凸畸形。其中男10例、女4例;结核性后凸9例,骨折继发性后凸3例,发育性后凸2例。平均后凸角(Cobb’s)71.08°。结果:所有病人安全完成手术,无脊髓和神经根损伤等并发症,手术平均矫正率为57.97%,随访6~28mo,融合效果满意,脊髓神经根功能明显改善。结论:对于不同原因脊柱后凸畸形的手术治疗,楔形三柱截骨术能够较好地重建脊柱的稳定性,解除脊髓神经根的压迫和牵张;采用AF内固定系统矫形固定,创面小,固定节段短,安装简便,用机械的力量缓慢渐进地矫形,疗效满意,并发症少。

SURGICAL TREATMENT OF SPINAL KYPHOSIS WITH WEDGED THREE- COLUMNIATION- OSTEOTOMY AND SHORT SEGMENT PEDICLE SCREW FIXATION SYSTEM

Objective:To evaluate the treatment of spinal kyphosis caused by different reasons.Methods:14 cases of spinal kyphosis were treated by wedged three-columniation-osteotomy and AF pedicle screw system fixation through posterior procedure.There were 10 male and 4 female with an average preoperative kyphosis of 71.08 degree.There were 9 cases of tuberculous kyphosis,3 cases of post-traumatic kyphosis and 2 cases of developmental kyphosis.Results: All patients underwent surgery safely and no severe complications occurred.The average correction of kyphosis was 57.97%.Postoperative follow up was ranged from 6 to 28 months,solid fusion was obtained.Obvious improvement was obtained in cases with neurological dysfunction.Conclusion:To treat the spinal kyphosis,wedged three-columniation-osteotomy can obtain adequate decompression and reconstruction of the spine.Internal fixation with AF pedicle screw system is a safe,straightforword and reliable technique which using controllable correction.