Li Xiangdong, Luo Zhuojing, Li Xinkui, Tao Huiren, Du Junjie, Wang Zhe
From the Institute of Orthopaedics, Xi-Jing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China.
Spine (Phila Pa 1976). 2008 Aug 15;33(18):2001-6. doi: 10.1097/BRS.0b013e31817d1d29.
A retrospective review of patient records was conducted.
To evaluate the results of a lumbar hemivertebra resection and short-segment fusion through a lateral-posterior approach.
Few reports have been reported describing a procedure consisting of one-stage lateral-posterior lumbar hemivertebra resection and correction of the deformity by segmental anterior instrumentation to date.
From 1998 to 2006, a consecutive series of twenty-four patients with congenital scoliosis or kyphoscoliosis due to a lumbar hemivertebra were managed by resection of the hemivertebra through a lateral-posterior approach and with the use of a short anterior convex-side fusion. RESULTS.: The mean age at the time of surgery was 9.4 years (range, 6 years and 8 months-16 years and 9 months). The mean follow-up period was 43 months (5-94). There was a mean improvement of 61.5% in the segmental scoliosis curve from a mean angle of 45.2 degrees before surgery to 17.4 degrees at the time of the latest follow-up assessment, and a mean improvement of 60.9% in the total main scoliosis curve from 47.6 degrees to 18.6 degrees at the same periods. The mean final lordosis was within normal values. There were no major complications and no neurologic damage.
Excision of a lumbar hemivertebra through lateral-posterior approach is safe and provides stable correction when combined with a short-segment fusion.
对患者病历进行回顾性研究。
评估经侧后方入路行腰椎半椎体切除及短节段融合术的效果。
迄今为止，鲜有报道描述一期经侧后方腰椎半椎体切除并通过节段性前路器械矫正畸形的手术。
1998年至2006年，连续24例因腰椎半椎体导致先天性脊柱侧凸或脊柱后凸侧凸的患者，采用经侧后方入路切除半椎体并使用短节段前路凸侧融合术进行治疗。结果：手术时的平均年龄为9.4岁（范围6岁8个月至16岁9个月）。平均随访期为43个月（5至94个月）。节段性脊柱侧凸曲线平均改善61.5%，术前平均角度为45.2度，最新随访评估时为17.4度；同期主脊柱侧凸总曲线平均改善60.9%，从47.6度降至18.6度。最终平均腰椎前凸在正常范围内。无重大并发症及神经损伤。
经侧后方入路切除腰椎半椎体是安全的，与短节段融合术联合应用时可提供稳定的矫正效果。
