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find Keyword "后路截骨术" 2 results
  • 后路全脊椎截骨联合椎弓根钉棒固定术治疗脊柱后凸畸形

    目的 总结后路全脊椎截骨联合椎弓根钉棒固定术治疗胸腰椎脊柱后凸畸形的手术方法及临床疗效。 方法 2003 年1 月- 2008 年1 月,采用后路全脊椎截骨联合椎弓根钉棒固定术治疗脊柱后凸畸形24 例。男15 例,女9 例;年龄21 ~ 68 岁,平均53 岁。先天性脊柱畸形2 例,结核性后凸9 例,陈旧创伤性后凸13 例。Frankel 分级:E 级14 例,D 级8 例,C 级2 例。后凸顶点分别位于:T11 5 例,T12 10 例,L1 7 例,L2 2 例。脊柱后凸Cobb 角为37 ~ 65°,平均46°。 结果 术后24 例均获随访,随访时间8 个月~ 3 年,平均2.5 年。根据自定评价标准,疗效优15 例,良7 例,可2例,优良率91.7%。术后3 个月Cobb 角为4.2 ~ 5.1°,平均5.3°,平均矫正率87.6%。术后2 例Frankel C 级均恢复至D 级;8 例D 级中5 例恢复至E 级,3 例无变化;余患者仍为E 级。术后8 ~ 12 个月X 线片可见原截骨平面发生骨性融合,未发现内植物松动、断裂、假关节形成和矫正度数丢失等并发症。 结论 后路全脊椎截骨联合椎弓根钉棒固定术损伤小、并发症少,减压、矫形可同时进行,治疗脊柱后凸畸形临床效果明显。

    Release date:2016-09-01 09:05 Export PDF Favorites Scan
  • Comparison of radiological changes after Halo-pelvic traction with posterior spinal osteotomy versus simple posterior spinal osteotomy for severe rigid spinal deformity

    ObjectiveTo compare the changes of scoliosis and kyphosis angles after Halo-pelvic traction with posterior spinal osteotomy versus simple posterior spinal osteotomy for severe rigid spinal deformity.MethodsA clinical data of 28 patients with severe rigid spinal deformity between January 2015 and November 2017 was retrospectively analyzed. Sixteen patients were treated by Halo-pelvic traction with posterior spinal osteotomy (group A) and 12 patients were treated with posterior spinal osteotomy only (group B). There was no significant difference between the two groups (P>0.05) in gender, age, body mass index, and preoperative pulmonary function, coronal and sagittal Cobb angles, and flexibility. The operation time, intraoperative blood loss, and complications were recorded. The coronal and sagittal Cobb angles were measured on X-ray films before operation (before traction in group A), at 10 days after operation, at last follow-up in the two groups and after traction in group A. The improvement rate of deformity after traction in group A, the correction rate of deformity after operation, and the loss rate of correction at last follow-up were calculated.ResultsAll patients were followed up 24-30 months (mean, 26.5 months). The operation time and intraoperative blood loss were significantly less in group A than in group B (t=7.629, P=0.000; t=8.773, P=0.000). In group A, 1 patient occurred transient numbness of both legs during continuous traction and 2 patients needed ventilator support for more than 12 hours. In group B, 7 patients needed ventilator support for more than 12 hours, including 1 patient with deep incision infection. The incidence of complications was 18.75% (3/16) in group A and 58.33% (7/12) in group B, and the difference between the two groups was significant (χ2=4.680, P=0.031). The coronal and sagittal improvement rates of deformity after traction in group A were 40.47%±3.60% and 40.70%±4.20%, respectively. There was no significant difference between the two groups (P>0.05) in the coronal and sagittal Cobb angles at 10 days after operation and at last follow-up, in the correction rate of deformity after operation, and in the loss rate of correction at last follow-up.ConclusionFor the severe rigid spinal deformity, Halo-pelvic traction with posterior spinal osteotomy and simple posterior spinal osteotomy can obtain the same orthopedic effect and postoperative deformity correction. However, the Halo-pelvic traction can shorten operation time, reduce blood loss and incidence of perioperative complications.

    Release date:2020-07-27 07:36 Export PDF Favorites Scan
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