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[后路脊柱松解术后头环-股骨牵引在重度僵硬型脊柱侧凸中的疗效]

[Effectiveness of halo-femoral traction after posterior spinal release in severe and rigid scoliosis].

作者信息

Qiu Yong, Liu Zhen, Zhu Feng, Wang Bin, Yu Yang, Zhu Ze-zhang, Qian Bang-ping, Ma Wei-wei

机构信息

Spine Surgery, Drum Tower Hospital, Nanjing University Medical College, Nanjing 210008, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2007 Apr 15;45(8):513-6.

Abstract

OBJECTIVE

To assess the effectiveness of Halo-femoral traction after posterior spinal release in the management of Congenital Scoliosis (CS) and Idiopathic Scoliosis (IS).

METHODS

Sixty consecutive patients with severe and rigid scoliosis treated with anterior spinal release and halo-femoral traction were recruited for this retrospective study. CS group included 30 patients (20 females and 10 males) and IS group has 30 patients (23 females and 7 males). The average coronal Cobb angle of the main curve before operation was 95.7 degrees in CS and 91.6 degrees in IS. The mean thoracic kyphosis was 70.2 degrees in CS and 50.6 degrees in IS. The average period of followed up was 38 months (range 12 - 72 months).

RESULTS

The average traction time was 23 days and weight was 16 kg. The mean Cobb angle correction rate after operation was 57.5% in IS and 45.2% in CS. The correction rate of coronal Cobb angle and kyphosis between IS and CS was statistically significant (t = -2.59, P < 0.05). Four patients experienced brachial plexus palsy and complete nerve functional restoration was achieved at two months follow-up.

CONCLUSIONS

Halo-femoral traction was a safe, well-tolerated and effective method for the treatment of severe and rigid scoliosis patients.

摘要

目的

评估后路脊柱松解术后头环股骨牵引在先天性脊柱侧凸(CS)和特发性脊柱侧凸(IS)治疗中的有效性。

方法

本回顾性研究纳入了60例连续接受前路脊柱松解和头环股骨牵引治疗的重度僵硬性脊柱侧凸患者。CS组包括30例患者(20例女性和10例男性),IS组有30例患者(23例女性和7例男性)。CS组术前主弯平均冠状面Cobb角为95.7度,IS组为91.6度。CS组平均胸椎后凸为70.2度,IS组为50.6度。平均随访时间为38个月(范围12 - 72个月)。

结果

平均牵引时间为23天,牵引重量为16千克。术后IS组平均Cobb角矫正率为57.5%,CS组为45.2%。IS组和CS组之间冠状面Cobb角和后凸的矫正率有统计学意义(t = -2.59,P < 0.05)。4例患者出现臂丛神经麻痹,在随访2个月时神经功能完全恢复。

结论

头环股骨牵引是治疗重度僵硬性脊柱侧凸患者的一种安全、耐受性良好且有效的方法。

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