Hong-Qi Zhang, Yong Chen, Jia Huang, Chaofeng Guo, Xiongke Hu
Department of Spinal Surgery, Xiangya Hospital of Central South University, Changsha, 410008, China,
Childs Nerv Syst. 2015 Aug;31(8):1347-54. doi: 10.1007/s00381-015-2738-y. Epub 2015 May 8.
The purpose of this study was to evaluate the clinical and radiographic outcomes of modified pedicle subtraction osteotomy (mPSO) for thoracolumbar post-tubercular kyphosis in pediatric patients.
From January 2008 to August 2012, 26 consecutive pediatric patients with thoracolumbar post-tubercular kyphosis underwent modified pedicle subtraction osteotomy (mPSO). The clinical and radiologic outcomes were analyzed preoperatively, postoperatively, and at the last follow-up.
Twenty-six patients with thoracolumbar post-tubercular kyphosis underwent mPSO. The average operation time was 256 min (188314 min). The mean follow-up was 41 months (1856 months). The mean estimated blood loss was 870 ml (620 ~ 1020 ml). The thoracolumbar kyphotic angle ranged from 51° to 79° before operation, 60.6° in average. The mean thoracolumbar kyphotic Cobb angle was 19.7° after operation, with a mean correction of 40.9°. The C7 sagittal plumb line was 3.8 cm after operation, comparing to the 10.5 cm preoperative. The mean preoperative angle of thoracic kyphosis (TK) was 9.9° ± 1.2° and increased to 11.8° ± 1.4°, postoperatively. Lumbar lordosis (LL) improved from -22.8° ± 4.9° preoperative to -17.8° ± 2.1° postoperative. Visual analogue scale (VAS) was 8.7 ± 1.1 preoperative and 1.2 ± 0.4 postoperative, respectively. The mean Oswestry Disability Index (ODI) improved from 49.2 ± 5.3 before surgery to 10.8 ± 3.3 postoperative (P < 0.01). All patients received good bone healing, no significant loss of correction angle. Most patients (24/26) considered pain and exterior was significantly improved.
Modified pedicle subtraction osteotomy (mPSO) is effective and reliable for thoracolumbar post-tubercular kyphosis in pediatric patients.
本研究旨在评估改良椎弓根截骨术（mPSO）治疗小儿胸腰椎结核后凸畸形的临床和影像学效果。
2008年1月至2012年8月，连续26例小儿胸腰椎结核后凸畸形患者接受了改良椎弓根截骨术（mPSO）。对术前、术后及末次随访时的临床和影像学结果进行分析。
26例胸腰椎结核后凸畸形患者接受了mPSO。平均手术时间为256分钟（188314分钟）。平均随访时间为41个月（1856个月）。平均估计失血量为870毫升（620~1020毫升）。术前胸腰椎后凸角为51°至79°，平均60.6°。术后胸腰椎后凸Cobb角平均为19.7°，平均矫正40.9°。术后C7矢状面垂直线为3.8厘米，术前为10.5厘米。术前胸椎后凸（TK）平均角度为9.9°±1.2°，术后增加至11.8°±1.4°。腰椎前凸（LL）从术前的-22.8°±4.9°改善至术后的-17.8°±2.1°。视觉模拟评分（VAS）术前为8.7±1.1，术后为1.2±0.4。平均Oswestry功能障碍指数（ODI）从术前的49.2±5.3改善至术后的10.8±3.3（P<0.01）。所有患者均获得良好的骨愈合，矫正角度无明显丢失。大多数患者（24/26）认为疼痛和外观有明显改善。
改良椎弓根截骨术（mPSO）治疗小儿胸腰椎结核后凸畸形有效且可靠。
