Shapiro Frederic, Sethna Navil
Department of Orthopaedic Surgery, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA.
Eur Spine J. 2004 Oct;13 Suppl 1(Suppl 1):S6-17. doi: 10.1007/s00586-004-0760-y. Epub 2004 Aug 13.
This article reviews the extent of blood loss in spine surgery for scoliosis corrections in the pediatric age group. An extensive literature review presents blood loss values in surgery for adolescent idiopathic scoliosis, cerebral palsy, Duchenne muscular dystrophy, spinal muscular atrophy, and myelomeningocoele. The underlying disorder plays a major role in determining the extent of blood loss. Blood loss is considerably higher in those patients with a neuromuscular scoliosis compared with adolescent idiopathic scoliosis. Within the neuromuscular group those with Duchenne muscular dystrophy demonstrate the highest mean levels of blood loss. Blood loss is also shown to be progressively greater with increasing numbers of vertebral levels incorporated into the fusion, with posterior fusions compared to anterior fusions, and in those patients having both anterior and posterior fusions.
本文综述了小儿年龄组脊柱侧弯矫正手术中的失血量。广泛的文献回顾展示了青少年特发性脊柱侧弯、脑瘫、杜氏肌营养不良、脊髓性肌萎缩和脊髓脊膜膨出手术中的失血量值。潜在疾病在决定失血量程度方面起主要作用。与青少年特发性脊柱侧弯相比,神经肌肉型脊柱侧弯患者的失血量要高得多。在神经肌肉型组中,患有杜氏肌营养不良的患者失血量平均水平最高。随着融合椎体节段数量的增加、与前路融合相比后路融合以及同时进行前路和后路融合的患者,失血量也逐渐增加。