摘要
目的探讨头盆环牵引辅助后路截骨矫形治疗重度僵硬型脊柱畸形的临床效果。方法回顾性分析2012年1月至2018年3月贵州省骨科医院收治的76例重度僵硬型脊柱畸形患者的临床资料。患者均采用后路截骨矫形手术,按是否实施头盆环牵引分为观察组(n=32)和对照组(n=44),观察组术前采用头盆环牵引3~4周(平均3.2周),对照组未行头盆环牵引。观察组患者记录牵引前后及手术前后Cobb角变化,计算牵引后和术后的侧后凸纠正率,同时与对照组的矫形效果进行比较。结果观察组头盆环牵引后平均侧凸、后凸纠正率分别为45.2%、53.7%。随访时间6~48个月(平均24个月)。观察组术中出血量及手术时间少于对照组,术后1周、末次随访时侧凸及后凸矫正率均优于对照组,两组比较,差异有统计学意义(P<0.05)。结论头盆环牵引辅助后路截骨矫形治疗重度僵硬型脊柱畸形,可预测患者对脊髓矫形的耐受程度,简化手术步骤,提高矫正率,是一种安全有效的治疗方法。
Objective To investigate the clinical effect of halo-pelvic traction assisted posterior osteotomy and correction in the treatment of severe rigid spinal deformity.Methods Clinical data of 76 patients with severe rigid spinal deformity treated from January 2012 to March 2018 in Guizhou Orthopedic Hospital were retrospectively analyzed.Patients were divided into observation group(n=32)and control group(n=44)according to whether or not implement halo-pelvic traction.Patients in observation group were treated with posterior osteotomy assisted by halo-pelvic traction for 3 to 4 weeks(average 3.2 weeks),while in control group,they were treated by the same osteotomy without the traction.For patients in observation group,changes of Cobb angles before and after the traction and the operation were recorded,the scoliosis and kyphosis correction rates were calculated,and then the correction effects were compared with the control group.Results In observation group,the average correction rate of scoliosis and kyphosis after the traction was 45.2%and 53.7%respectively.The follow-up time was from 6 to 48 months(average,24 months).The estimate intraoperative blood loss and operation time in observation group were less than those in control group;At 1 week postoperatively,and at the latest follow-up,the scoliosis and kyphosis correction rates in observation group were all better than those in control group.The differences between two groups showed statistically significant(P<0.05).Conclusion Halo-pelvic traction assisted posterior osteotomy and correction for severe rigid spinal deformity is a safe and effective method which can predict the tolerance of spinal cord orthopedics,simplify the surgical procedure,and improve the correction rate.
作者
陈啟鸰
王力航
欧阳北平
陆廷盛
姚书眈
罗春山
CHEN Qiling;WANG Lihang;OUYANG Beiping;LU Tingsheng;YAO Shudan;LUO Chunshan(Department of Spinal surgery,Guizhou Orthopedic Hospital,Guiyang,Guizhou 550002,China)
出处
《中国骨科临床与基础研究杂志》
2020年第2期87-93,共7页
Chinese Orthopaedic Journal of Clinical and Basic Research
基金
贵州省科技支撑计划项目(黔科合支撑[2020]4Y131)
贵州省卫生计生委科学技术基金项目(gzwjkj2018-1-042)。
关键词
脊柱弯曲
牵引术
手法
骨科
截骨术
Spinal curvatures
Traction
Manipulation
orthopedic
Osteotomy
