经椎弓根截骨术治疗胸腰椎后凸畸形

目的评估经椎弓根截骨术矫正胸腰椎后凸畸形的临床疗效和安全性。方法2001年3月~2007年4月,15例胸腰椎后凸畸形患者进行经椎弓根截骨矫形术。其中强直性脊柱炎8例,陈旧性胸腰椎骨折7例。对所有患者进行随访,内容包括矫正情况、腰痛和Oswestry功能评分的变化。结果平均随访时间为25个月。平均手术时间为230min,术中平均出血量为1780ml。术前后凸Cobb角平均为47.2°,术后为18.0°,平均矫正角度32.3°,融合率80%。术前患者腰痛VAS评分平均为7.4分,术后3.7分。术前ODI平均为58.9%,术后为30.0%。患者主观满意率93.3%。无术中和术后并发症。结论经椎弓根截骨术对于矫正胸腰椎后凸畸形有效而安全,应该根据患者的实际情况选择合适的截骨部位。

Pedicle subtraction osteotomy in the treatment of thoracolumbar kyphotic deformity

Objective To evaluate the efficacy and safety of the pedicle subtraction osteotomy (PSO) in the treatment of thoracolumbar kyphotic deformity. Methods Fifteen patients of thoracolumbar kyphosis underwent PSO from Mar 2001 to Apr 2007 were reviewed, among which were 8 cases of ankylosing spondylitis and 7 cases of post-traumatic kyphosis. Pre- and post-operative kyphotic Cobb angle, VAS of back pain, Oswestry Disablity Index, as well as the incidence of complication were accessed. Results Mean follow-up duration was 25 months. Average operative time was 230 min and average bleeding was 1780ml. Average Cobb angle was 47.2° pre-operatively and 18.0° post-operatively, with a mean correction of 32.3°, the fusion rate was 80%. Average VAS of back pain was 7.4 pre-operatively and 3.7 post-operatively. Average ODI was 58.9% pre-operatively and 30.0% post-operatively. Rate of satisfaction was 93.3% without intra- and post-operative complications. Conclusion Pedicle Subtraction Osteotomy is an effective and safe procedure to correct the thoracolumbar kyphosis, personalized choice of osteotomy level is critical.