Banta J V
Department of Orthopaedic Surgery, Newington Children's Hospital, Connecticut.
Spine (Phila Pa 1976). 1990 Sep;15(9):946-52. doi: 10.1097/00007632-199009000-00020.
Since 1973, 50 of 54 children have been treated by the author with a combined anterior and posterior fusion. Twenty males and 34 females, ranging in age from 1 to 16 years, have been followed for a mean period of 5.5 years. Sixteen patients with a kyphosis averaging 113 degrees (range, 77 to 170 degrees) had correction of deformity to a mean of 35 degrees. Thirty-seven patients with a scoliosis averaging 73 degrees (range, 20 to 135 degrees) had correction to an average of 34 degrees (range, 0 to 75 degrees). There were 4 cases of deep wound infection successfully treated with drainage and antibiotics and only one case required implant removal after fusion/maturation. A pseudarthrosis was noted by radiograph in 6 patients, 3 of whom had isolated asymptomatic lumbosacral pseudarthroses. Three patients had pseudarthrosis at the thoracolumbar junction. These required repair and were successfully treated by supplemental posterior fusion resulting in an overall pseudarthrosis rate of 5.7%. Anterior fusion of the dysraphic spine allows greater correction of both spinal deformity and pelvic obliquity in addition to contributing significant strength to the fusion mass. Segmental spinal instrumentation with sublaminar and pedicular wiring to custom-contoured Luque rods provides excellent correction and immediate postoperative stability.
自1973年以来，作者对54例儿童中的50例进行了前后联合融合治疗。其中20名男性和34名女性，年龄在1至16岁之间，平均随访时间为5.5年。16例平均后凸角度为113度（范围为77至170度）的患者，畸形矫正至平均35度。37例平均脊柱侧凸角度为73度（范围为20至135度）的患者，矫正至平均34度（范围为0至75度）。有4例深部伤口感染经引流和抗生素治疗成功，只有1例在融合/成熟后需要取出植入物。6例患者经X线片发现假关节形成，其中3例为孤立性无症状腰骶部假关节。3例患者在胸腰段交界处出现假关节。这些患者需要修复，通过补充后路融合成功治疗，总体假关节发生率为5.7%。除了显著增强融合块的强度外，脊柱裂脊柱的前路融合还能更好地矫正脊柱畸形和骨盆倾斜。采用椎板下和椎弓根钢丝固定至定制塑形的Luque棒的节段性脊柱内固定提供了出色的矫正效果和术后即刻稳定性。
