一期后路截骨矫正儿童WinterⅡ型先天性脊柱后凸
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郑州大学第三附属医院

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河南省医学科技攻关计划联合共建项目(LHGJ20190384)


One-stage posterior osteotomy for correction of Winter II congenital kyphosis in children
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The third affiliated Hospital of Zhengzhou University

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Joint Construction Project of Henan Medical Science and Technology Research Program(LHGJ20190384)

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    摘要:

    目的:观察采用后路截骨联合内固定术治疗单纯WinterⅡ型先天性脊柱后凸的手术效果。方法:收集2006年-2017年与我院就诊并行手术治疗的单纯WinterⅡ型先天性脊柱后凸患儿13例,均行一期经后路Schwab截骨联合内固定手术,根据患儿年龄、后凸部位及病变范围确定截骨方式,术后佩戴支具,维持矫正效果。术前、术后及随访均行全脊柱正侧位X线片,测量并分析患儿脊柱后凸角度变化。结果:13例患儿均顺利完成手术,未出现严重并发症,术前合并神经系统症状者得到改善。平均随访66.42±33.45月(范围:36-120月),术后及末次随访时,患儿矢状位及冠状位畸形较术前均有明显改善,主弯Cobb角变化均有统计学差异(P<0.05),矢状位胸椎后凸角(Thoracic kyphosis, TK)、腰椎前凸角(Lumbar lordosis, LL)及骨盆角(T1-Pelvic angle, TPA)变化较术前亦均有统计学差异(P<0.05)。结论:后路截骨联合内固定术是治疗单纯WinterⅡ型先天性脊柱后凸的有效手术方式且能控制畸形进展。

    Abstract:

    Objective: To observe the surgical results of using posterior osteotomy combined with internal fixation in the treatment of simple Winter II congenital kyphosis. Methods: Thirteen children with simple Winter II congenital kyphosis who attended our hospital and were treated surgically from 2006 to 2017 were collected, and all underwent a one-stage trans-posterior Schwab osteotomy combined with internal fixation. Pre-operative, post-operative and follow-up radiographs of the whole spine were taken to measure and analyze the change in the angle of kyphosis of the children. Results: All 13 children completed the surgery successfully without serious complications, and those with preoperative combined neurological symptoms were improved. At the mean follow-up of 66.42±33.45 months (range: 36-120 months), the sagittal and coronal deformities of the children were significantly improved after surgery and at the last follow-up compared with those before surgery. The changes in the sagittal thoracic kyphosis (TK), lumbar lordosis (LL) and pelvic angle (T1-Pelvic angle, TPA) were also statistically different from those before surgery (P<0.05). Conclusion: Posterior osteotomy combined with internal fixation is an effective surgical procedure for simple Winter II congenital kyphosis and can control the progression of the deformity.

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  • 收稿日期:2022-04-14
  • 最后修改日期:2022-07-30
  • 录用日期:2022-11-25
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