儿童脊柱侧凸非融合手术治疗的发展及现状

背景：儿童脊柱侧凸的治疗是脊柱外科的挑战之一,外科手术治疗尚没有满意的方法. 目的：综述儿童脊柱侧凸外科治疗方法的发展及现状,分析各种方法的利弊,展望儿童脊柱侧凸非融合手术治疗的发展. 方法：以“Scoliosis,Infantile scoliosis,Juvenile scoliosis,fusionless surgery,spinal implant”为英文检索词,“脊柱侧凸,少儿型脊柱侧凸,青少年型脊柱侧凸,脊柱内固定器,脊柱侧凸非融合手术”为中文检索词,检索Pubmed数据库、CNKI数据库2001至2012年发表的相关文献.共检索到113篇文献,排除无关重复的文献,保留36篇进行综述. 结果与结论：目前脊柱侧凸外科治疗主要方法中,撑开技术可以保证脊柱的生长但需要不断的后期延长,生长导向技术可以避免不断的延长手术,但脊柱的生长不能得到保证,也不能纠正脊柱的旋转畸形;而生长调节技术对脊柱畸形的纠正有一定的作用,但它对严重脊柱畸形的作用是不确定的;可生长三维矫形技术的动物实验证明既能保证脊柱的生长,同时能纠正脊柱的旋转,术后不需要不断地延长,理论上是较理想的治疗方法,需要临床研究验证.

Development and current situation of non-fusion surgery for the treatment of scoliosis in children

BACKGROUND：Treatment of scoliosis in children is a chal enging in spinal surgery. To date, there is no satisfactory surgical method for the treatment of scoliosis in children. OBJECTIVE：To review the development and current situation of the non-fusion surgery for the treatment of children with scoliosis, to analyze the pros and cons of various methods and to prospect the future. METHODS：The PubMed database and CNKI database from 2001 to 2012 were retrieved by computer with the key words of“scoliosis, infantile scoliosis, juvenile scoliosis, fusionless surgery, spinal implant”in English and Chinese. A total of 113 literatures were screened out, and then the repetitive and irrelevant researches were eliminated, then 36 literatures were included for the final review. RESULTS AND CONCLUSION：To date, among the main methods of scoliosis surgery, lengthening technology can guarantee the growth of the spine, but subsequent lengthening surgery was needed;growth guiding technology could avoid subsequent lengthening surgery, but the growth of spine could not be guaranteed and could not correct the rotational deformity of spine;growth regulating technology could correct deformity, but the capacity of serious spinal deformity was indeterminacy;animal experiment of automatic growth three-dimensional orthopaedic technology has demonstrated that it could guarantee the growth of the spine, and could correct the deformity at the same time without subsequent lengthening surgery. Theoretical y, automatic growth three-dimensional orthopaedic technology is the perfect solution for children scoliosis, but it stil needs clinical checking.