引用本文:罗春山,邱 冰,陆庭盛,姚书丹,赵筑川,王玉松.后路脊柱截骨矫形术治疗脊柱后凸畸形的临床探讨[J].重庆医科大学学报,2013,(11):1275~1277
后路脊柱截骨矫形术治疗脊柱后凸畸形的临床探讨
Posterior osteotomy in the treatment of spinal kyphosis
DOI:
中文关键词:  脊柱后凸  截骨术  内固定术
英文关键词:kyphosis  osteotomy  internal fixation
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罗春山,邱 冰,陆庭盛,姚书丹,赵筑川,王玉松 贵州省骨科医院骨科脊柱外科贵州 550003 
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中文摘要:
      目的:总结脊柱后路截骨矫形术治疗脊柱后凸畸形的治疗经验。方法:5例强直性脊柱炎患者平均后凸角度在79.0°,行L1、L3双节段楔形截骨矫形术,5例外伤性或结核性角状后凸脊柱畸形角度小于50.0°者采用单节段楔形截骨闭合矫形术,5例大于50.0°者采用单节段截骨前方垫高、后方闭合矫形术,对这些临床资料进行回顾性分析。结果:15例患者得到术后平均11个月的随访,于术后6个月均获得骨性融合。术前后凸角平均为62.3°,术后后凸角平均为15.5°,平均矫正度数为46.8°,矫正率为75.1%;术后平均身高增加4.4 cm。术前5例神经损害病例,C级1例恢复至D级,C级1例恢复至E级,D级3例恢复至E级;腰背部疼痛不适症状明显减轻。结论:弧形后凸畸形,可通过多椎体楔形截骨增加截骨度数,大角度角状后凸畸形可通过单节段截骨前方垫高、后方闭合矫形术增加矫形度数,后路楔形截骨矫形术是治疗脊柱后凸畸形的有效方法。
英文摘要:
      Objective:To summarize the experiences of posterior osteotomy for spinal kyphosis. Methods:Five patients with ankylosing spondylitis and an average kyphosis angle of 79.0° underwent double-segment wedge osteotomy in L1 and L3. Five patients with trau-matic or tuberculosis kyphosis and kyphosis angle less than 50.0° underwent single-segment wedge closing osteotomy. Five patients with kyphosis angle more than 50.0° underwent osteotomy with cage inserting anteriorly and closing posteriorly. Their clinical data were retrospectively analyzed. Results:Fifteen patients had an average of 11 months’ follow-up. All had bone-fusion at six months after the operation. Average kyphosis angle was 62.3° preoperatively and 15.5° postoperatively. Average correction angle and rate of kyphosis were 46.8° and 75.1% respectively. Average height was increased by 4.4 cm. For five patients with nervous injury,one pa-tient with Frankle C recovered to Frankle D;one with Frankle C to Frankle E,and three with Frankle D to Frankle E. Back pain was released obviously. Conclusions:Long round-shaped deformity can be corrected through multi-vertebral osteotomy. Severe kyphosis can be corrected through osteotomy with cage inserting anteriorly and closing posteriorly. Osteotomy correction by posterior approach is an effective method for spinal kyphosis.
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