People.s Hospital of Bayingolin Mongolian Autonomous Prefecture of China
摘要：[目的] 探讨后路截骨矫治胸腰椎陈旧性骨折后凸畸形临床疗效。[方法] 回顾性分析2006年9月-2019年6月用后路截骨矫治陈旧性胸腰椎骨折后凸畸形患者41例，男32例,女9例,平均年龄42.3(24—71)岁；首次骨折至本次入院病程5—31年,平均14.56年。后凸畸形Cobb’s角(64.86±15.59)°。7例行SPO截骨术，20例行PSO截骨术，11例行BDBO截骨术，3例行PVCR截骨术。对手术前、后和末次随访测定VAS评分、ODI功能指数、ASIA脊髓功能分级和运动功能评分、畸形矫正率和脊髓功能变化进行统计学分析，评定疗效。[结果]经12-72个月（平均36.7个月）随访，术后12个月Cobb’s角为（13.96±3.56），后凸畸形矫正率78.56%；末次随访Cobb’s角（14.82 ±1.20）°，较术后12个月无明显丢失（P>0.05)。 VAS 评分、ODI功能指数、ASIA脊髓功能评分较术前明显改善（P<0.001），术后18个月截骨端均骨性愈合。[结论] 后路截骨矫治胸腰椎陈旧性骨折后凸畸形可获良好矫形和重建脊柱平衡效果，截骨端融合率高，并发症少,并促进脊髓功能恢复。
[Objective] To investigate the clinical effect of posterior osteotomy in the treatment of thoracolumbar vertebral kyphosis with old fracture.[Methods]A retrospective analysis was performed on 41 patients with old thoracolumbar fracture kyphosis treated by posterior osteotomy from September 2006 to June 2019, including 32 males and 9 females, with an average age of 42.3(24-71) years; The duration from the first fracture to this admission was 5-31 years, with an average of 14.56 years.Kyphosis Cobb's Angle (64.86±15.59)°.SPO osteotomy was performed in 7 patients, PSO osteotomy in 20 patients, BDBO osteotomy in 11 patients and PVCR osteotomy in 3 patients.VAS score, ODI function index, ASIA spinal cord function grade and motor function score, deformity correction rate and spinal cord function changes were statistically analyzed before, after and at the last follow-up to evaluate the efficacy.[Results] After 12-72 months of follow-up (mean 36.7 months),Cobb's Angle 12 months after operation was (13.96±3.56) , and the correction rate of kyphosis was 78.56%. Cobb's Angle (14.82 ±1.20) ° at the last follow-up showed no significant loss compared with 12 months after operation (P> 0.05). VAS score, ODI function index and ASIA spinal cord function score were significantly improved (P< 0.001), osseous union was found in all osteotomy ends 18 months after operation.[Conclusion]Posterior osteotomy for the treatment of thoracolumbar vertebral fracture kyphosis can achieve good orthopedic and spinal balance reconstruction, high osteotomy end fusion rate, fewer complications, and promote the recovery of spinal cord function.