Aydogan Mehmet, Ozturk Cagatay, Tezer Mehmet, Mirzanli Cuneyt, Karatoprak Omer, Hamzaoglu Azmi
Istanbul Spine Center, Florence Nightingale Hospital, Istanbul, Turkey.
J Pediatr Orthop B. 2008 Jan;17(1):33-7. doi: 10.1097/01.bpb.0000218031.75557.f0.
Vertebrectomy and instrumentation only via the posterior approach has been increasingly used in sagittal, frontal plane and combined deformities. The aim of this retrospective study is to evaluate the clinical and radiological results of hemivertebrectomy and instrumentation only via the posterior approach in congenital spinal deformities. Between 1998 and 2003, we performed hemivertebrectomy and interbody fusion using posterior instrumentation with titanium mesh cage via the posterior approach in 19 patients (three scoliosis, five kyphosis and 11 kyphoscoliosis). The age of the patients ranged from 2 to 22 years and they all underwent hemivertebrectomy (at thoracic level in six patients, at thoracolumbar level in eight patients and at lumbar level in five patients). A titanium mesh cage was used for anterior column support and interbody fusion in patients who had residual anterior gap preventing bone-to-bone contact. Correction and stabilization were achieved by posterior polyaxial pedicle screws. Follow-up was an average of 4.6 years (range: 2-7 years). We did not confront any loss of correction, pseudoarthrosis, and titanium mesh cage collapse or implant failure. Hemivertebrectomy and instrumentation via the posterior approach is a good one-stage surgical treatment option that can be used to avoid the surgical trauma and morbidity related to anterior surgery. It is a technically demanding surgical procedure, however, requiring extreme care and experience in spine surgery.
仅通过后路进行椎体切除术和器械植入术已越来越多地应用于矢状面、额状面及联合畸形的治疗。本回顾性研究的目的是评估仅通过后路进行半椎体切除术和器械植入术治疗先天性脊柱畸形的临床和影像学结果。1998年至2003年间，我们对19例患者（3例脊柱侧凸、5例脊柱后凸和11例脊柱后凸侧凸）采用后路钛网笼后路器械植入术进行了半椎体切除术和椎间融合术。患者年龄为2至22岁，均接受了半椎体切除术（6例位于胸段，8例位于胸腰段，5例位于腰段）。对于存在残留前方间隙阻碍骨对骨接触的患者，使用钛网笼进行前柱支撑和椎间融合。通过后路多轴椎弓根螺钉实现矫正和稳定。平均随访4.6年（范围：2至7年）。我们未遇到任何矫正丢失、假关节形成、钛网笼塌陷或植入物失败的情况。仅通过后路进行半椎体切除术和器械植入术是一种良好的一期手术治疗选择，可避免与前路手术相关的手术创伤和并发症。然而，这是一种技术要求较高的手术操作，需要脊柱外科方面的极度谨慎和经验。
