摘要
目的探讨儿童静止期脊柱结核性后凸(侧后凸)畸形采用一期后路截骨矫形和内固定治疗的疗效。方法纳入我院2010年1月至2015年12月收治<16岁儿童脊柱结核患者共44例,均采用后路截骨矫形植骨融合内固定术治疗。术前、术后及随访时摄站立位全脊柱X线片,测量矢状面主弯后凸Cobb′s角、冠状面主弯侧凸Cobb′s角及躯干矢状偏移距离、VAS量表评分。结果 44例患儿成功完成手术和进行完整随访,随访时间为10~100月,平均31.2月。随访期间患儿均未发生骨吸收、骨不连和假关节形成等并发症。术后与术前主弯矢状面后凸Cobb′s角、主弯冠状面后凸Cobb′s角和矢状面躯干偏移对比差异有统计学意义(P<0.05);术前与末次随访主弯矢状面后凸Cobb′s角、主弯冠状面后凸Cobb′s角和矢状面躯干偏移对比差异具有统计学意义(P<0.05)。采用Ridit分析VAS量表结果显示:术前R=0.653,95%可信区间为(0.573~0.734),术后R=0.437,95%可信区间为(0.377~0.497),两组无可重复区间,比较具有统计学意义;末次随访R=0.410,95%可信区间为(0.355~0.465),与术前比较无可重复区间,比较具有统计学意义;术后与末次随访比较具有可重复区间,比较无统计学意义(P>0.05)。结论针对儿童静止期脊柱结核性后凸(侧后凸)畸形采用一期后路截骨矫形及内固定具有明显疗效,且安全性较高,值得在临床上推广实施。
Objective To investigate the curative effect of Posterior osteotomy correction and internal fixation on the resting stage of spinal tuberculosis kyphosis and side convex deformity in children. Methods 44 children younger than 16 years with resting stage of spinal tuberculosis kyphosis were treated with posterior osteotomy correction and internal fixation. The sagittal kyphotic Cobb＇s angles, coronal kyphotic Cobb ＇s angles, sagittal trunk shift and VAS scale were observed. Results 44 children successfully completed surgery and completely followed-up. The follow-up period did not occur bone resorption, bone non--union and pseudarthrosis. The sagittal kyphotic Cobb＇s bending angle, coronal kyphotic Cobb＇s bending angle and sagittal trunk shift before and after treatment were different （P〈0.05）. 95% confidence interval of VAS scale before operation （0. 573~0. 734） and that of after operation （0. 377-0. 497） and last followed-up （0. 355-0. 465） had not repeated interval （P〈0.05）. 95 - confidence interval of VAS scale after operation and last followed-up （0. 355-0. 465） had repeated interval （P〈0.05）. 95% confidence interval of VAS scale before operation （0. 573 - 0. 734） and that of last followed-up （0. 355- 0. 465） had not repeated interval. Conclusion It is effective and safe to treat quiescent stage of spinal tuberculosis kyphosis and side convex deformity in children with posterior osteotomy correction and internal fixation.
作者
黄南翔
林宏
李伟
HUANG Nanxiang LIN Hong LI Wei(Department of Orthopaedic Surgery, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College, Nanchong 637000, Sichuan, Chin)
出处
《西部医学》
2017年第2期241-244,共4页
Medical Journal of West China
基金
四川省南充市科学技术计划项目(15A0039)
关键词
儿童
脊柱结核
内固定
截骨术
Child
Spinal tuberculosis internal fixation
Osteotomy
