%0 Journal Article
%T 后路全脊椎截骨联合椎弓根螺钉治疗胸腰椎脊柱后凸畸形
%A 蒋成
%A 蒋萍
%A 蔚？
%J 华西医学
%P 1035-1037
%D 2011
%X 【】　目的　探讨经后路全脊截骨联合椎弓根螺钉治疗胸腰椎脊柱后凸畸形的手术评估和临床疗效。　方法　2004年4月－2010年6月采用后路脊椎截骨椎弓根螺钉内固定治疗脊柱后凸畸形15例，其中男11例，女4例；年龄16~61岁，平均49岁。陈旧性胸腰椎骨折后凸10例，结核后凸3例，椎体发育不良2例；后凸顶点胸9椎体1例，胸11椎体3例，胸12椎体4例，腰1椎体5例，腰2椎体2例。脊柱后凸Cobb角35~61°，平均46°。Frankel分级E级2例，D级8例，C级4例，B级1例。　结果　术中出血800~1800mL，平均1000mL；术中1例左侧胸神经根损伤；1例术后双下肢肌力感觉减退。15例患者均获随访，随访时间10~30个月，平均12个月。术后6个月Cobb角5~10°，平均矫正率86.5%。术后6~10个月X线片显示截骨平面骨性愈合，术后神经功能恢复情况，除1例B级恢复至D级外，其余为E级。内固定物无松动、断裂和纠正度数丢失等并发症。　结论　经后路脊柱截骨联合椎弓根螺钉内固定具有减压、矫形同时进行，矫正度数大，并发症少，临床效果明显。【Abstract】　Objective　Toexplorethesurgeryassessmentandclinicaloutcomeofthetreatmentforthoracolumbarkyphosisbywholeposteriorspinalosteotomycombinedwithpediclescrew.　Methods　Fifteenpatientsincluding11malesand4femaleswithkyphosisweretreatedbyposteriorspinalosteotomycombinedwithpediclescrewfromApril2004toJune2010.Theageofthemrangedfrom16to61yearsoldaveragingat49.Therewere10casesofoldthoracolumbarfracturekyphosis,3casesoftuberculosiskyphosis,and2casesofpoorvertebralgrowth.Asforkyphosisvertices,therewere1caseofT9,3casesofT11,4casesofT12,5casesofL1,and2casesofL2.KyphosisCobbanglerangedfrom35°to61°,averagingat46°.BasedonFrankeGrade,therewere2gradeEcases,8gradeDcases,4gradeCcases,and1gradeBcase.　Results　Intraoperativebloodlosswasfrom800to1800mLwithanaverageof1000mL;Therewas1caseofleftthoracicnerverootinjuryduringoperationand1caseoflowerextremitymusclestrengthhypoesthesiaafteroperation.Allthe15patientswerefollowedupfor10to30monthswithanaveragetimeof12months.Sixmonthsaftersurgery,Cobbanglerangedfrom5°to10°,withanaveragecorrectionrateof86.5%.Sixtotenmonthsafterosteotomy,Xrayshowedagoodbonehealingcondition.Asfortherecoverystatusofneurologicalfunctionaftersurgery,AllpatientsrecoveredtogradeEexcept1patientwhoreturnedtogradeDfromgradeB.Nosuchcomplicationsasfixationwithoutloosening,fractureorlossofcorrectiondegreeoccurred.　Conclusion　Inposteriorspinalosteotomycombinedwithpediclescrewfixation,decompressionandcorrectioncanbecarriedoutatthesametimetocorrectalargedegreeofkyphosiswithfewcomplications.Theclinicaleffectisobvious.
%K 脊柱后凸畸形
%K 截骨矫形
%K 椎弓根螺钉固定
%U http://www.hxyxqk.com.cn/oa/DArticle.aspx?type=view&id=201107023