1.the Third Affiliated Hospital of Zhengzhou University;2.The Third Affiliated Hospital of Zhengzhou University
目的 探讨脊柱后路椎体-椎间盘-椎体截骨术(Bone-Disc-Bone Osteotomy，BDBO)治疗儿童先天性脊柱畸形的疗效。方法 回顾性分析2003年01月～2017年06月本院32例行后路BDBO的先天性脊柱畸形患儿，年龄15天～15岁，平均(4.38±3.97)岁，术前、术后及末次随访时均行平卧位或站立位全脊柱正侧位X线片，测量侧凸及后凸Cobb角，记录手术时间、出血量及并发症情况。结果 平均手术时间(239.44±48.19)min，出血量(304.38±150.10)ml，随访2年～13年，平均(5.90±2.76）年。术前、术后、末次随访侧凸Cobb角分别为(40.13±18.27)°、(10.44±6.04)°、(8.84±6.98)°，后凸Cobb角为(29.72±20.66)°、(8.84±12.67)°、(5.91±16.55)°，术后及随访Cobb角与术前相比差异均有统计学意义(P＜0.05)。所有患儿无脊髓损伤及椎弓根骨折,术后切口感染行内固定取出1例。结论 脊柱后路BDBO能有效治疗儿童先天性脊柱畸形，适合用于早期轻型先天性脊柱畸形及腰骶段半椎体，可避免固定髂骨。
Abstract: [Objective] To explore the effective of posterior spinal bone-disc-bone osteotomy (BDBO) for congenital spinal deformity in young children. [Methods]The clinical data of 32 young children with congenital spinal deformity treated with posterior BDBO method from January 2003 to June 2017 were analyzed retrospectively. These patients with a mean age of(4.38±3.97) years old (range: 15 days to 15 years old).The anteroposterior and lateral X-ray films of the whole spine in standing position or supine position were taken before operation，postoperative and the last follow-up.The correction of deformity was evaluated by measuring the angle of scoliosis and kyphosis (Cobb angle).The time of operations and intraoperative blood loss，the late complication were recorded.[Results]The mean operative duration and blood loss were (239.44±48.19)min and (304.38±150.10) ml. All the children were followed up for 2 to 13 years, with an average of (5.90±2.76）years. The mean preoperative, postoperative and the last follow-up Coronal Cobb angle were (40.13±18.27)°, (10.44±6.04)°, (8.84±6.98)°, kyphosis Cobb angle were (29.72±20.66)°, (8.84±12.67)°, (5.91±16.55)°.Statistical analysis showed that the differences between preoperative and postoperative were significant(P＜0.05).No spinal cord injury or pedicle fracture occurred in all children. One case underwent internal fixation removal because of repeated incision infection and non-healing after operation. [Conclusions] Posterior spinal BDBO for congenital spinal deformities in children has a good effect. It is more suitable for early mild congenital spinal deformities and lumbosacral hemivertebra, and can avoid ilium fixation.