Song Xi-zheng, Yi Guo-liang, Wang Wen-jun, Li Hong-ke, Wang Dong, Song Lin-zhang
Department of Spine, the First Affiliated Hospital of Nanhua University, Hengyang 421001, Hunan, China.
Zhongguo Gu Shang. 2011 Sep;24(9):737-41.
To evaluate the clinical curative effect of the modified Halo pelvic frame and surgery for the treatment of severe scoliosis with rigidity.
From January 2004 to May 2010,50 patients with severe scoliosis patients with rigidity were treated in our hospital. Twenty-three patients were male and 27 patients were female, with a mean age of 10.8 years old, ranging from 4 to 16 years. Twenty-four patients were congenital scoliosis and 26 patiens were idiopathic scoliosis. The mean body height were (152.1 +/- 11.1) cm and the average Cobb angle of scoliosis and kyphosis were (91.8 +/- 14.5) degrees and (69.5 +/- 14.0) degrees respectively. All the patients were treated with three-stages modified Halo pelvic traction, the second stage anterior release and the third stage posterior correction. The amount of correction was determined by measuring the change of body height, the Cobb angles and correction rate of scoliosis as well as kyphosis before and after the operation.
The mean body height were correct to (158.5 +/- 10.5) cm. The average Cobb angle of scoliosis were correct to (30.8 +/- 7.9) degrees. The average Cobb angle of kyphosis were correct to (31.6 +/- 10.1) degrees. After the first stage, the average Cobb angle of scoliosis and kyphosis were changed with the mean of (30.4 +/- 6.6)% correction and (22.3 +/- 5.2)% respectively; after the second stage, the average Cobb angle of scoliosis and kyphosis were changed with the mean (26.7 -/+ 5.1)% correction and (21.2 -/+ 6.0)% respectively; the third stage, above data were (33.7 -/+ 7.2)% and (27.1 +/- 5.3)%. Correction rate of scoliosis and kyphosis were (66.5 +/- 7.2)% and (55.1 +/- 6.4)% respectively by the modified Halo pelvic frame traction and surgery. Body height, the Cobb angles and correction rate of scoliosis and kyphosis on radiographs were different in all stages (P<0.05).
Operative complications of severe scoliosis with rigidity can be reduced and better deformity correction and trunk balance achieved by the modified Halo pelvic frame traction and surgery.
评估改良头环骨盆固定架及手术治疗重度僵硬型脊柱侧凸的临床疗效。
2004年1月至2010年5月，我院收治50例重度僵硬型脊柱侧凸患者。男23例，女27例，平均年龄10.8岁，年龄范围4至16岁。先天性脊柱侧凸24例，特发性脊柱侧凸26例。平均身高为（152.1±11.1）cm，脊柱侧凸和后凸的平均Cobb角分别为（91.8±14.5）°和（69.5±14.0）°。所有患者均接受三阶段改良头环骨盆牵引、第二阶段前路松解及第三阶段后路矫正治疗。通过测量手术前后身高变化、Cobb角以及脊柱侧凸和后凸的矫正率来确定矫正量。
平均身高矫正至（158.5±10.5）cm。脊柱侧凸平均Cobb角矫正至（30.8±7.9）°。后凸平均Cobb角矫正至（31.6±10.1）°。第一阶段后，脊柱侧凸和后凸平均Cobb角分别以（30.4±6.6）%和（22.3±5.2）%的幅度改变；第二阶段后，脊柱侧凸和后凸平均Cobb角分别以（26.7±5.1）%和（21.2±6.0）%的幅度改变；第三阶段，上述数据分别为（33.7±7.2）%和（27.1±5.3）%。改良头环骨盆固定架牵引及手术治疗后，脊柱侧凸和后凸的矫正率分别为（66.5±7.2）%和（55.1±6.4）%。各阶段身高、Cobb角以及脊柱侧凸和后凸的矫正率在X线片上均有差异（P<0.05）。
改良头环骨盆固定架牵引及手术可减少重度僵硬型脊柱侧凸的手术并发症，并实现更好的畸形矫正和躯干平衡。
