Zhou Chunguang, Liu Limin, Song Yueming, Liu Hao, Zeng Jiancheng, Yang Xi
Department of Orthopedics, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
Eur Spine J. 2015 Jul;24(7):1560-7. doi: 10.1007/s00586-015-3902-5. Epub 2015 Mar 27.
To evaluate the outcome and complications of anterior release, posterior internal distraction and subsequent posterior spinal fusion for the treatment of severe kyphoscoliosis.
The medical records and spinal imaging of 17 consecutive severe kyphoscoliosis patients who underwent anterior release, posterior internal distraction and subsequent posterior spinal fusion were reviewed.
Patients underwent spinal deformity correction at the mean age of 22.6 ± 8.4 years (range 15-44 years) with mean follow-up of 37.4 ± 12.0 months (range 24-60 months). The preoperative thoracic kyphosis of 83.5° ± 16.3° (range 60°-115°) was corrected to 37.5° ± 7.9° (range 20°-49°) at the final follow-up. The preoperative major curve of 110.1° ± 16.8° (range 92°-145°) was corrected to 33.5° ± 13.9° (range 12°-63°) at the final follow-up, with a scoliosis correction of 70.3 %. At the most recent follow-up, the correction rate of proximal thoracic curve and thoracolumbar or lumbar curve was 57.1 and 74.8 %, respectively. Transient dyspnoea occurred in one patient after the initial surgery and subsequently resolved. No ventilator support was needed. Three patients complained the pain of concave soft tissue after the first distraction. There were no neurological complications or any deep wound infections. No complication of instrumentation was found at final follow-up.
In the treatment of severe kyphoscoliosis, anterior release, posterior internal distraction and subsequent posterior spinal fusion, which obviates three-column osteotomy, is a good alternative correction method.
评估前路松解、后路内撑开及随后的后路脊柱融合术治疗重度脊柱侧凸的疗效及并发症。
回顾性分析17例连续接受前路松解、后路内撑开及随后后路脊柱融合术的重度脊柱侧凸患者的病历及脊柱影像学资料。
患者接受脊柱畸形矫正手术的平均年龄为22.6±8.4岁（范围15 - 44岁），平均随访时间为37.4±12.0个月（范围24 - 60个月）。末次随访时，术前83.5°±16.3°（范围60° - 115°）的胸椎后凸矫正至37.5°±7.9°（范围20° - 49°）。术前110.1°±16.8°（范围92° - 145°）的主弯在末次随访时矫正至33.5°±13.9°（范围12° - 63°），脊柱侧凸矫正率为70.3%。在最近一次随访时，近端胸椎曲线和胸腰段或腰段曲线的矫正率分别为57.1%和74.8%。1例患者术后初期出现短暂性呼吸困难，随后缓解，无需呼吸机支持。3例患者在首次撑开后抱怨凹侧软组织疼痛。未发生神经并发症或深部伤口感染。末次随访时未发现内固定并发症。
在重度脊柱侧凸的治疗中，前路松解、后路内撑开及随后的后路脊柱融合术避免了三柱截骨，是一种较好的矫正方法。
