摘要
目的评价一期后路全脊椎切除治疗僵硬性胸腰椎后凸畸形临床效果。方法对25例脊柱僵硬性后凸畸形患者采用一期全脊椎切除截骨,对手术前、后Frankel神经功能分级、Oswestry评分进行评定,观察术后恢复情况。结果 25例均获随访,时间14～31个月。脊柱后凸Cobb角:术前为30°～100°(60.3°±7.5°),术后为5°～58°(21.4°±3.4°),矫正率为49.1%～87.6%(62.5%±4.2%);末次随访时为9°～62°(25.9°±5.7°),矫正率为44.1%～85.6%(57.1%±5.1%),丢失6.5°±1.2°。Frankel分级:末次随访时B级2例恢复至C级,C级6例恢复至E级3例、D级3例,D级5例恢复至E级4例、1例无恢复。Oswestry评分:术前为8.2～33.5(17.34±4.2)分,术后为4.1～25.3(11.75±3.5)分,改善率为30.2%～69.7%(45.7%±6.7%)。结论一期后路顶椎附近椎体全脊椎切除治疗脊柱后凸畸形矫正效果满意,疗效良好。
Objective To evaluate the efficacy of one stage posterior total vertebral column resection for stiff kyphosis of thoracolumbar spine. Methods 25 patients with adopted one stage posterior total vertebral column resection. Frankel neural function grading, Oswestry scores, postoperative recovery were recored. Results All patients were followed up for 14 -31 months. The preoperative Cobb angle was 30° - 100°（60. 3° ±7. 5°） , and the angle was immediately improved to 5° -58° （21.4° ± 3.4°） postoperatively, the average correct rate was 49. 1% - 87. 6% （62. 5% ± 4. 2% ） ; At the time of the final follow-up, the Cobb angle was 9 ° - 62 ° （ 25.9 ° ± 5.7°）, the average correct rate was 44. 1% -85.6% （57.1% ±5.1% ）, the average toss angle was 6. 5° ± 1.2°. Frankel classification： preoperative total of 2 cases B, 6 cases C, 5 cases D,12 cases E. At the final follow-up, 2 B cases back to the C level, 3 C cases back to E and 3 C cases back to D,4 cases D back to E, and 1 D got no improvement. Preoperative Oswestry scores ： 8.2 - 33.5 （ 17. 34 ± 4. 2）, postoperative was 4.1 - 25.3 （ 11.75 ± 3.5 ）, improvement rate was 30. 2% -69. 7% （45. 7% ±6. 7% ）. Conclusions One stage posterior vertebral column resection is an effective surgical technique for managing severe and rigid kyphosis.
出处
《临床骨科杂志》
2013年第4期361-364,共4页
Journal of Clinical Orthopaedics
关键词
脊柱后凸
全脊椎截骨术
spine kyphosis
total vertebra column resection
作者简介
张元豫，男，副主任医师，主要从事脊柱畸形研究，E—mail：zhangyuanyu1974@163．com；
李坤，男，主任医师，通讯作者，主要从事脊柱畸形、骨肿瘤研究，E-mail：likun1959@163．com
