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在患有脊髓脊膜膨出后凸畸形的儿童中使用拉力螺钉进行椎体切除和椎间融合固定术:一例技术病例报告

Kyphectomy and interbody fixation using lag screws in a child with myelomeningocele kyphosis: a technical case report.

作者信息

Wui Seong-Hyun, Hyun Seung-Jae, Kim Ki-Jeong, Jahng Tae-Ahn, Kim Hyun Jib

机构信息

Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul, Republic of Korea.

出版信息

Childs Nerv Syst. 2019 Aug;35(8):1407-1410. doi: 10.1007/s00381-019-04217-w. Epub 2019 May 28.

Abstract

A 5-year-old boy had a thoracolumbar-level MMC that had been repaired at the day after birth and kyphotic deformity got worse as he grew. He complained of discomfort about not being able to take a supine posture and decided to perform surgery for kyphosis. In our case, surgical correction is offered to stop the deformity progression, manage the associated pain, and finally to gain sitting and supine posture. We report the surgical procedure with 4 levels of en bloc kyphectomy and using the lag screws. Especially when lag screws are used, several complications including posterior instrumentation failure, hardware prominence and wound break down can be solved by removing the implants after bone fusion has been achieved.

摘要

一名5岁男孩患有胸腰段脊髓脊膜膨出,出生后第二天已进行修复,随着生长,后凸畸形逐渐加重。他因无法仰卧而感到不适,遂决定接受脊柱后凸手术。在我们的病例中,进行手术矫正以阻止畸形进展、控制相关疼痛,并最终获得坐姿和仰卧姿势。我们报告了采用四级整块椎体切除并使用拉力螺钉的手术过程。特别是在使用拉力螺钉时,包括后路内固定失败、内固定物突出和伤口裂开等多种并发症,可在实现骨融合后通过取出植入物来解决。

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