凸侧短段固定凹侧生长棒技术治疗小儿神经纤维瘤病脊柱侧弯

摘要

目的：回顾性分析应用椎弓根钉结合凸侧短段固定凹侧生长棒技术治疗小儿神经纤维瘤病合并脊柱侧弯的结果及初步经验。方法自2012年3月至2014年7月我们收治Ⅰ型神经纤维瘤病伴脊柱侧弯12例，其中男8例，女4例。平均年龄4．6岁，平均随访时间1．1年。根据放射学表现确定其中10例为神经纤维瘤病营养不良型脊柱侧弯，行椎弓根钉凸侧固定凹侧生长棒技术治疗。结果脊柱侧弯冠状面及矢状面矫形率分别为55％和30％。随访中丢失角度为冠状面5°、矢状面3°。3例出现了脑脊液漏，继续撑开能维持矫正效果。结论应用椎弓根钉结合凸侧固定凹侧生长棒技术治疗小儿神经纤维瘤病脊柱侧弯，疗效确切，并发症少。%Objetive A retrospective study of operative treatment in patients with scoliosis caused by neurofibromatosis in order to introduce the initial experience.The operative pattern is fixing on convex side by pedicle screw combined with growing rod technique on concave. Methods Twelve patients(8 male and 4 fe-male)with scoliosis caused by neurofibromatosis-Ⅰ were treated surgicaly from March 201 2 to July 201 4 with mean age of 4.6 years and mean follow-up period of 1 .1 years.Ten of them were dystrophic curves depending on the characters by radiographs.The operative pattern was fixing on convex side by pedicle screw combined with opening on concave side by subcutaneous bar.Results The correction rates in coronary and sagittal plane were 55% and 30% respectively.The mean lost of Cobb angle were 5 degrees and 3 degrees respectively at fol-low-up.Three cases had the complication of leakage of cerebrospinal fluid .The reopening can maintain the ef-fort. Conclusions Treating scoliosis caused by neurofibromatosis with fixing on convex side by pedicle screw combined with growing rod on concave side can improve the deformity and maintain the effort.The complication is rare.