目的：探究后路半椎体切除椎弓根器械固定治疗小儿先天性脊柱侧凸的临床疗效及其预后方法选取我院自2009年4月～2015年4月收治的59例先天性脊柱侧凸的患儿，在术前根据影像学资料测定每位患儿脊柱的Cobb角。在全身麻醉下，对患儿进行脊柱后路半椎体切除，并使用ISOLA在术后对患儿脊柱进行固定。观察患儿脊柱畸形纠正状况以及躯干的稳定性，测定患儿脊柱Cobb角的纠正率，并在术后随访1～5年，对患儿的生活质量进行跟踪评定。结果颈段半椎体术后Cobb角为（12.8°±0.4°），矫正率为36.9％；胸段半椎体术后Cobb角为（23.4°±0.8°），矫正率为50.4％；腰段半椎体术后Cobb角为（10.1°±0.1°），矫正率为70.7％，三种半椎板类型手术前后Cobb角有差异（P<0.05）。患儿在术后生理领域评分为（78.2±3.2），心理领域评分为（83.2±8.6），独立性领域评分为（89.4±4.3），总生活质量评分为（88.6±10.3）。结论后路半椎体切除椎弓根器械固定可早期纠正先天性脊柱侧凸患儿的脊柱畸形，增加躯干稳定性，无感染、损伤脊髓等并发症，可提高患儿在术后的生活质量。%Objective To explore the clinical effect of posterior vertebral resection half congenital scoliosis fixation of pedicle instrument and its prognosis. Methods59 cases of congenital scoliosis from our hospital from April 2009 to April 2015 were treated. Preoperative Cobb angle was measured every spine in children under imaging data. Under general anesthesia, the patients were treated with the posterior vertebral body and the ISOLA was used to fix the spine. The correction of spinal deformity and the stability of the trunk were observed, and the correction rate of Cobb angle was measured. The quality of life of the patients was folowed up for 1 to 5 years.ResultsPostoperative cervical hemivertebrae Cobb angle was (12.8°±0.4°), the correction rate was 36.9%, thoracic surgery hemivertebrae Cobb angle was (23.4°±0.8°), the correction rate was 50.4%;lumbar vertebrae postoperative Cobb angle half was (10.1°±0.1°), the correction rate was 70.7%. Children in the field of physiology scores was (78.2±3.2), physical domain scores was (83.2 ± 8.6), the scores of the independence was (89.4±4.3), the overal quality of life scores was (88.6 ± 10.3).Conclusion Posterior pedicle instrument mounting half corpectomy and early corrective congenital spinal deformity in children with scoliosis of the spine increase the trunk stability, no infection, spinal cord injury and other complications and improve the lives of children in the postoperative quality.
展开▼
