摘要
目的探讨PSO＋SPO联合截骨术治疗胸腰椎后凸畸形的临床疗效。方法 2009年1月至2014年3月共收治25例严重胸腰椎后凸畸形患者,其中胸腰椎陈旧性骨折18例,强直性脊柱炎7例,年龄21~54岁,平均39.1岁,后凸Cobb角度平均45.8°±7.3°;所有患者一期行PSO＋SPO联合截骨术,患者术后均接受至少1年的临床及影像学随访。在术前、术后6个月及12个月时,测量Cobb角度、用视觉模拟疼痛（VAS）评分、功能障碍指数（ODI）评分对患者手术的临床及影像学效果进行评估。结果所有病例均获骨性愈合,平均愈合时间为5.6个月。在Cobb角、VAS疼痛评分、ODI评分方面,术后6个月和末次随访较手术前差异均有统计学意义（P〈0.05）。1例患者出现术后神经损害,Frankel分级为C级,3个月后恢复至E级。结论应用PSO＋SPO联合截骨术治疗胸腰椎后突畸形可获得满意的矫形效果与短中期临床疗效。
Objective To explore the clinical effect of the combined osteotomy of PSO and SPO for treatment of thoracolumbar kyphosis. Methods From January 2009 to March 2014, 25 cases of severe thoracolumbar kyphosis were treated with mean age 39.1 years（ranging from 21 to 54 years）, among which 18 patients were diagnosed with old posttraumatic thoracolumbar kyphosis, the other 7 cases were ankylosing spondylitis patients. The average sagittal Cobb′s angle was 45.8°±7.3°. All cases were treated by the combined osteotomy of PSO and SPO, with the clinical and imageology follow-up at least 1 year. The sagittal Cobb′s angle of the thoracolumbar kyphosis, the Visual Ana Iog Scale, the Oswestry Disability Index were evaluated pre-operatively and 6 months post-operatively and 12 months post-operatively. Results Imageology examination confirmed that solid bone healing was achieved in all of the patients in average 5.6 months. The sagittal Cobb′s angle, the Visual Ana Iog Scale and the Oswestry Disability Index were distinguished improved at 6 months post-operatively and 12 months post-operatively, the difference has statistical significance（P〈0.05）. One post-operatively nervous lesion case achieved Frankel＇s class E from class C after 3 months post-operatively. Conclusion Applying the combined osteotomy of PSO and SPO to treat severe thoracolumbar kyphosis can obtain satisfactory orthopaedic outcome and short-term and intermediate clinical effect.
出处
《中华临床医师杂志（电子版）》
CAS
2016年第3期373-376,共4页
Chinese Journal of Clinicians(Electronic Edition)
关键词
胸椎
腰椎
脊柱后凸
脊柱融合术
截骨术
Thoracic vertebrae
Lumbar vertebrae
Kyphosis
Spinal fusion
Osteotomy
