文章摘要
薛旭红,张麒,赵胜,等.凹侧撑开预矫形技术治疗重度僵硬性脊柱侧凸的早期研究.骨科,2023,14(2): 132-137.
凹侧撑开预矫形技术治疗重度僵硬性脊柱侧凸的早期研究
Early Study on the Treatment of Severe Rigid Scoliosis with the Distraction on Concave Side
投稿时间:2023-01-17  
DOI:DOI:10.3969/j.issn.1674-8573.2023.02.008
中文关键词: 重度特发性脊柱侧凸  凹侧  预矫形  二次矫形
英文关键词: Severe and idiopathic scoliosis  Concave side  Pre-orthopaedic  Secondary orthopaedic
基金项目:国家自然科学基金面上项目(82272575);山西省自然科学研究面上项目(202203021211041)
作者单位E-mail
薛旭红 山西医科大学第二医院骨科太原 030001  
张麒 山西医科大学第二医院骨科太原 030001山西医科大学第二临床医学院太原 030001  
赵胜 山西医科大学第二医院骨科太原 030001 zhaosheng0807@163.com 
张艳东 山西医科大学第二医院骨科太原 030001山西医科大学第二临床医学院太原 030001  
王世雄 山西医科大学第二医院骨科太原 030001山西医科大学第二临床医学院太原 030001  
席凡辉 山西医科大学第二医院骨科太原 030001山西医科大学第二临床医学院太原 030001  
葛贵喧 山西医科大学基础医学院生物化学与分子生物学教研室太原 030606  
郭伟杰 山西医科大学第二临床医学院太原 030001  
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中文摘要:
      目的 研究凹侧撑开预矫形技术治疗重度僵硬性特发性脊柱侧凸的早期疗效和安全性。方法 回顾性分析2020年1月至2022年12月山西医科大学第二医院收治并进行手术治疗的重度僵硬性脊柱侧凸的8例病人的临床资料。手术均采用凹侧撑开预矫形后双侧依次上棒二次矫形的手术方法。分别测量术前、术后及末次随访时的影像学参数包括主弯Cobb角、次弯Cobb角、胸椎后凸角(TK)、腰椎前凸角(LL)、主弯顶椎偏距(AVT)、躯干偏移(TS)。结果 病人随访(9.0±6.3)个月(1~16个月)。术前主弯Cobb角:97.4°±10.0°,次弯Cobb角:55.6°±8.4°,TK:50.4°±20.3°,LL:62.7°±6.3°,AVT:(7.64±1.55) cm,TS:(2.00±1.93) cm;术后即刻主弯Cobb角:25.8°±8.1°,次弯Cobb角:21.0°±12.0°,TK:24.9°±9.6°,LL:31.6°±11.9°,AVT:(2.34±1.45) cm,TS:(1.26±0.63) cm;末次随访主弯Cobb角:21.2°±9.1°,次弯Cobb角:22.4°±16.1°,TK:32.8°±12.0°,LL:37.6°±14.0°,AVT:(2.41±0.81) cm,TS:(1.6±1.4) cm。除TS外,上述其他指标术后即刻、末次随访时的数值与术前比较,差异有统计学意义(P<0.05),但术后即刻与末次随访时的数值比较,差异无统计学意义(P>0.05)。1例术后7个月出现迟发性感染,遂进行手术清创以及内固定取出术后再愈合。结论 采用凹侧撑开预矫形治疗重度脊柱侧凸能够获得满意的矫形效果,且出血少,术中及术后神经系统并发症发生率低,是一种安全有效且实用的治疗方法。
英文摘要:
      Objective To study the early efficacy and safety of concave distraction technique in the treatment of severe rigid idiopathic scoliosis. Methods The clinical data of 8 patients with severe rigid scoliosis admitted and operated in the Second Hospital of Shanxi Medical University from January 2020 to December 2022 were analyzed retrospectively. During operation, one short rod was implanted into the concave side and distended, and then double long rods were implanted in bilateral sides. Main curve Cobb angle, compensatory curve Cobb angle, thoracic kyphosis (TK), lunbar lordosis (LL), apex vertebra translation (AVT) and trunk shift (TS) were measured through standing posterior-anterior (PA) X-ray pre-operatively, post-operatively and at the final follow-up. Results The patients were followed up for (9.0±6.3) months (1-16 months). The main curve, compensatory curve, thoracic kyphosis, lumbar lordosis, AVT and TS were 97.4°±10.0°, 55.6°±8.4°, 50.4°±20.3°, 62.7°±6.3°, (7.64±1.55) cm and (2.00±1.93) cm preoperatively, which were improved to 25.8°±8.1°, 21.0°±12.0°, 24.9°±9.6°, 31.6°±11.9°, (2.34±1.45) cm and (1.26±0.63) cm postoperatively, and 21.2°±9.1°, 22.4°±16.1°, 32.8°±12.0°, 37.6°±14.0°, (2.41±0.81) cm and (1.6±1.4) cm at the last follow-up. Except TS, the values of the other indicators mentioned above at the immediate and last follow-up after operation were significantly different from those before operation (P<0.05), but there was no statistically significant difference in the values between the immediate and last follow-up after operation (P>0.05). One patient developed delayed infection 7 months after surgery, and then healed again after surgical debridement and internal fixation removal. Conclusion Treatment of severe rigid scoliosis with the distraction on concave side can achieve satisfactory orthopedic effect, less bleeding and low incidence of intraoperative and postoperative neurological complications. It is a safe, effective and practical treatment method.
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