Wang Sheng-ru, Zhang Jian-guo, Qiu Gui-xing, Li Shu-gang, Yu Bin
Department of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730, China.
Zhonghua Wai Ke Za Zhi. 2011 May 1;49(5):409-13.
To evaluate the efficacy and complications of posterior hemivertebra resection with monosegmental fusion in the treatment of congenital scoliosis.
Thirty consecutive cases of congenital scoliosis managed by posterior hemivertebra resection with monosegmental fusion of the two adjacent vertebra were investigated retrospectively. Radiographs were reviewed to determine the coronal curve magnitude and sagittal alignment preoperatively, postoperatively and at last follow-up. Operative reports and patient charts were reviewed to record any perioperative and late complications.
The total number of resected hemivertebra was 30. Mean operation time was 193.8 min with average blood loss of 369.0 ml. The segmental scoliosis was corrected from 36.4° to 4.9° with a correction rate of 86.5%, and segmental kyphosis (difference to normal segmental alignment) from 21.2° to 6.6° with a correction rate of 68.9%. The trunk shift was improved from 17.1 to 8.8 mm. The correction of the compensatory cranial and caudal curve were 74.9% and 75.1%. There were 1 delayed wound healing, 2 pedicle cutting and 1 rod breakages. Radiolucent gaps were found on the lateral view in 2 cases without any sign of implant failure and correction loss.
Posterior hemivertebra resection with monosegmental fusion of the two adjacent vertebra allows for early intervention in very young children. Excellent correction in the frontal and sagittal planes can be obtained. And a short segment of fusion allows for normal growth in the unaffected parts of the spine. The most common complication is implant failure.
评估后路半椎体切除单节段融合术治疗先天性脊柱侧凸的疗效及并发症。
回顾性研究30例采用后路半椎体切除并对相邻两节椎体进行单节段融合治疗的先天性脊柱侧凸患者。复查X线片以确定术前、术后及末次随访时的冠状面弯曲度数和矢状面排列情况。查阅手术报告和患者病历以记录任何围手术期及远期并发症。
共切除30个半椎体。平均手术时间为193.8分钟，平均失血量为369.0毫升。节段性脊柱侧凸从36.4°矫正至4.9°，矫正率为86.5%；节段性后凸（与正常节段排列的差值）从21.2°矫正至6.6°，矫正率为68.9%。躯干偏移从17.1毫米改善至8.8毫米。代偿性的头侧和尾侧弯曲的矫正率分别为74.9%和75.1%。出现1例伤口愈合延迟、2例椎弓根切割和1例棒断裂。2例患者在侧位片上发现透亮间隙，无任何内植物失败和矫正丢失的迹象。
后路半椎体切除并对相邻两节椎体进行单节段融合术可对幼儿进行早期干预。可在额状面和矢状面获得良好矫正。短节段融合可使脊柱未受影响部分正常生长。最常见的并发症是内植物失败。
