目的 报道一种新的经前路矫正少儿脊柱结核所致严重后凸畸形的手术方法.方法 运用前路后凸顶椎前移的方法治疗少儿脊柱结核伴后凸畸形5例,对比术前、术后影像学检查,了解矫形效果.结果 5名患儿随访6～24个月,平均14.2个月；术前脊髓神经症状在术后一段时间均完全消失,无医源性脊髓神经并发症发生.后凸角度(Cobb角)由术前32～55°平均42.2 °,改善为术后5～26°平均12.8 °；内固定物无松动、断裂,植骨融合.初期治疗效果较满意.结论 前路后凸顶椎前移法是矫正少儿脊柱结核所致非僵硬严重后凸畸形可选择的一种有效方法.%Objectives A new surgical technique to collect severe kyphosis in children caused by spinal tuberculosis was reported. Method The kyphotic deformity in 5 children with spinal tuberculosis was corrected using the apical vertebra anterior shift method via anterior approach. Results All the S children were followed up for an average of 14.2 months ( rage 6-24 months ) The spinal cord and neural deficit discovered before the operation all vanished after a certain period of time post-operatively. No iatrogenic cord or neural complication was noted. The kyphotic Cobb angle diminished from 42.2° in average (range 32~55° ) to 12.8° in average (rage 5~26° ) No instrument failure was detected. Bony fusion was achieved in all 5 cases. The early curative effect proved to be acceptable. Conclusions The anterior shift of apical vertebra via anterior approach is an effective option to correct severe non-rigid kyphosis in juvenile caused by spinal tuberculosis.
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