各型内固定矫形术治疗脊柱侧凸效果评价

目的评价不同内固定矫形术治疗脊柱侧凸的效果。方法对１９８４～１９９７年用不同手术方法矫治１２５例１００°以内脊柱侧凸患者的治疗和随诊资料进行研究,手术方法包括Ｈａｒｉｎｇｔｏｎ、Ｌｕｑｕｅ、联合ＨａｒｉｎｇｔｏｎＬｕｑｕｅ、ＣＤ、Ｚｉｅｌｋｅ、前路松解加后路手术和俄式手术等,对不同方法的优缺点及各自的矫正情况、身高变化、手术时间、术中输血量、住院时间、术后并发症和矫正度丢失情况及其原因进行比较分析。结果Ｈａｒｉｎｇｔｏｎ法矫正效果比其它方法差而且并发症多;Ｌｕｑｕｅ法费时且有潜在脊髓损伤之忧;ＣＤ法有三维矫正作用,矫正效果好,未见脱钩、断棍;含前路手术的方法远期Ｃｏｂｂ角度丢失少,其中前路松解加后路手术（ＣＤ术）方法简便易行,效果好;俄式手术作为一种探索中的不影响脊柱生长发育的新型脊柱侧凸内固定矫形术,有一定优越性。结论在不进行脊柱融合的新技术发展成熟前,ＣＤ术对生长发育中的青少年脊柱侧凸患者是一种较好的治疗方法

The effects of different instrumentation on scoliosis

OBJECTIVE: To investigate the effectiveness of the treatment of scoliosis with different surgical methods. METHOD: 125 cases of scoliosis less than 100 degrees treated during 14 years (1984 - 1997) were analyzed. Different operative methods were compared for their advantages and disadvantages, i.e. results and complications 10 months after operation and follow-up. RESULT: Harrington instrumentation was less effective in scoliotic curve correction and had more complications than other procedures. Luque technique needed longer operation time for wire passage at each level and had risk of neurological damage. CD and Zielke method showed 10% - 20% curve correction. No dislodgment of hook and fractured rods was found in the CD group. Anterior release plus posterior instrumentation was superior to other techniques. CONCLUSION: Treatment of scoliosis with anterior release plus posterior CD is practical for children before a new technique without spinal fusion is developed.