Helenius I, Serlo J, Pajulo O
Department of Paediatric Orthopaedics and Traumatology, Turku University Central Hospital, Kiinamyllynkatu 4-8, FIN-20521, Finland.
J Bone Joint Surg Br. 2012 Jul;94(7):950-5. doi: 10.1302/0301-620X.94B7.28545.
We report the results of vertebral column resection (VCR) for paediatric patients with spinal deformity. A total of 49 VCRs in paediatric patients from four university hospitals between 2005 and 2009 with a minimum two-year follow-up were retrospectively identified. After excluding single hemivertebral resections (n = 25) and VCRs performed for patients with myelomeningocele (n = 6), as well as spondylectomies performed for tumour (n = 4), there were 14 patients who had undergone full VCR at a mean age of 12.3 years (6.5 to 17.9). The aetiology was congenital scoliosis in five, neuromuscular scoliosis in three, congenital kyphosis in two, global kyphosis in two, adolescent idiopathic scoliosis in one and secondary scoliosis in one. A total of seven anteroposterior and seven posterolateral approaches were used. The mean major curve deformity was 86° (67° to 120°) pre-operatively and 37° (17° to 80°) at the two-year follow-up; correction was a mean of 54% (18% to 86%) in the anteroposterior and 60% (41% to 70%) in the posterolateral group at the two-year follow-up (p = 0.53). The mean Scoliosis Research Society-24 total scores were 100 (92 to 108) for the anteroposterior and 102 (95 to 105) for the posterolateral group. There was one paraparesis in the anteroposterior group necessitating urgent re-decompression, with a full recovery. Patients undergoing VCR are highly satisfied after a successful procedure.
我们报告了小儿脊柱畸形患者行脊柱椎体切除术(VCR)的结果。回顾性分析了2005年至2009年间来自四家大学医院的小儿患者的49例VCR手术,所有患者均至少随访两年。排除单一半椎体切除术(n = 25)、脊髓脊膜膨出患者的VCR手术(n = 6)以及肿瘤患者的椎体切除术(n = 4)后,有14例患者接受了完整的VCR手术,平均年龄为12.3岁(6.5至17.9岁)。病因包括先天性脊柱侧弯5例、神经肌肉型脊柱侧弯3例、先天性后凸2例、全身性后凸2例、青少年特发性脊柱侧弯1例和继发性脊柱侧弯1例。总共采用了7例前后路和7例后外侧入路。术前平均主弯畸形为86°(67°至120°),两年随访时为37°(17°至80°);两年随访时,前后路组平均矫正率为54%(18%至86%),后外侧组为60%(41%至70%)(p = 0.53)。脊柱侧弯研究学会-24总分平均前后路组为100(92至108),后外侧组为102(95至105)。前后路组有1例发生轻瘫,需要紧急再次减压,最终完全恢复。成功接受VCR手术的患者满意度很高。