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颅骨-股骨牵引后截骨矫正是治疗脊髓分裂畸形严重脊柱侧凸的一种安全有效的方法。

Skull-femoral traction followed by osteotomy correction is a safe and effective treatment for severe scoliosis with split cord malformation.

机构信息

Guizhou University of Traditional Chinese Medicine, Guiyang, China.

Guizhou Provincial People's Hospital, Guiyang, China.

出版信息

PLoS One. 2024 Sep 12;19(9):e0309646. doi: 10.1371/journal.pone.0309646. eCollection 2024.

DOI:10.1371/journal.pone.0309646
PMID:39264942
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11392416/
Abstract

OBJECTIVE

This study aimed to evaluate the safety and efficacy of skull-femoral traction followed by osteotomy correction in patients with severe spinal scoliosis and split cord malformation.

METHODS

We retrospectively analyzed ten cases of severe spinal scoliosis with Pang I type split cord malformation treated between August 2012 and August 2023. Patients underwent skull-femoral traction prior to osteotomy correction. We assessed changes in height, weight, coronal and sagittal Cobb's angles, and physiological indicators such as vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and blood gas levels before, during, and after treatment.

RESULTS

Traction duration ranged from 9 to 19 days, with height and weight showing significant increases post-treatment. The coronal Cobb's angle improved from pre-treatment to post-corrective surgery and remained stable at the final follow-up. Similar improvements were observed in the sagittal plane. Physiological indicators such as VC, FVC, and FEV1, as well as blood gas levels, normalized after treatment. Nutritional status, indicated by triceps skinfold thickness, albumin, and transferrin concentrations, also improved. No neurological complications or device-related complications occurred during or after treatment.

CONCLUSION

Skull-femoral traction followed by osteotomy correction is a safe and effective treatment for severe spinal scoliosis with split cord malformation, offering an alternative to high-risk procedures.

摘要

目的

本研究旨在评估颅骨股骨牵引联合截骨矫正术治疗严重脊柱侧凸伴脊髓分裂畸形患者的安全性和有效性。

方法

回顾性分析 2012 年 8 月至 2023 年 8 月收治的 10 例严重脊柱侧凸伴 Pang I 型脊髓分裂畸形患者。患者均接受颅骨股骨牵引后行截骨矫正术。评估治疗前后身高、体重、冠状面和矢状面 Cobb 角以及肺活量（VC）、用力肺活量（FVC）、第一秒用力呼气容积（FEV1）等生理指标和血气水平的变化。

结果

牵引时间为 9~19 天，治疗后身高和体重均显著增加。冠状面 Cobb 角从术前至术后矫正阶段改善，在最终随访时保持稳定。矢状面也观察到类似的改善。VC、FVC 和 FEV1 等生理指标以及血气水平在治疗后均恢复正常。三头肌皮褶厚度、白蛋白和转铁蛋白浓度等营养状况也得到改善。治疗过程中或治疗后均未发生神经并发症或器械相关并发症。

结论

颅骨股骨牵引联合截骨矫正术治疗严重脊柱侧凸伴脊髓分裂畸形是一种安全有效的方法，为高风险手术提供了替代选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb03/11392416/17730b63e79a/pone.0309646.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb03/11392416/01435bd587a0/pone.0309646.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb03/11392416/af79d479ff55/pone.0309646.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb03/11392416/4f1f625c9e87/pone.0309646.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb03/11392416/17730b63e79a/pone.0309646.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb03/11392416/01435bd587a0/pone.0309646.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb03/11392416/af79d479ff55/pone.0309646.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb03/11392416/4f1f625c9e87/pone.0309646.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb03/11392416/17730b63e79a/pone.0309646.g004.jpg

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Pulmonary Recovery Following Corrective Surgery in Adult Patients With Severe Scoliosis: A Minimum of Five-Year Follow-Up.成年重度脊柱侧弯患者矫正手术后的肺部恢复：至少五年随访
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Predictive factors for correction rate in severe idiopathic scoliosis (Cobb angle ≥ 90°): an analysis of 128 patients.
严重特发性脊柱侧凸（Cobb 角≥90°）矫正率的预测因素：128 例患者分析。
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