诱发电位监测下经椎弓根截骨短节段固定治疗创伤后脊柱后凸畸形

摘要

Objective:To evaluate the curative effect of somatosensory evoked potential monitoring in transpedicular spinal osteotomy and short-segment fixation for correction of post-traumatic kyphosis.Method:From March 2005 to July 2013,a total of 11 patients with post-traumatic thoracolumbar kyphosis received transpedicular wedge osteotomy and trans-disc osteotomy by using evoked potential monitoring,after removal of convex vertex,the system of imaging was examinated in the osteotomy for correction before and after operation,and the change of Cobb angle before and after operation were observed by X-ray examination.Result:Cobb angle markedly improved after operation in all case,without any deterioration in the later visit.All cases were followed up for 4-72 months,average 28 months.The pain of all the patients were disappeared,and resumed work and normal life.Bone graft fusion time was 4-6 months.Conclusion:Somatosensory evoked potential monitoring in transpedicular spinal osteotomy and short-segment fixation for correction of post-traumatic kyphosis is safe and reliable, and is proved to be an ideal treatment.%目的：探讨诱发电位监测下经椎弓根截骨短节段固定治疗创伤后脊柱后凸畸形的疗效。方法：笔者2005年3月-2013年7月在采用诱发电位监测下，单纯后路经椎弓根+椎间盘截骨路径，切除后凸顶点（包括伤椎后上角和伤椎上方椎间盘），截骨矫正手术前、后进行系统影像学检查，测量胸腰段Cobb角的变化，治疗11例胸腰椎创伤后凸畸形。结果：术后全部后突畸形均明显矫正，随访无明显加重。随访时间为4~72个月，平均28个月，所有患者疼痛消失，恢复正常的生活和工作，植骨融合时间为4~6个月。结论：诱发电位监测下经椎弓根+椎间盘截骨治疗陈旧性胸腰段脊柱骨折后凸畸形安全、可靠，是一种有效的治疗手段。