Otsuka N Y, Hey L, Hall J E
Department of Orthopaedic Surgery, Children's Medical Center, University of California, San Francisco, USA.
Clin Orthop Relat Res. 1998 Sep(354):189-94. doi: 10.1097/00003086-199809000-00023.
This is a retrospective review of 12 patients treated for severe postlaminectomy and postirradiation kyphosis by one surgeon from 1977 to 1994. The average age of the patients was 15 years with a range from 2 to 35 years. The duration of followup ranged from 24 months to 156 months with an average of 65 months. All patients had undergone multilevel laminectomies or irradiation of the thoracic or lumbar spine for an intraspinal lesion or trauma. The average preoperative kyphosis was 84 degrees and this was reduced to an average of 39 degrees after surgery. There were no pseudarthroses and there was an average loss of correction of 5 degrees. There were no complaints of back pain. Moderately severe but flexible kyphoses were treated in three patients by posterior instrumentation and spinal fusion. The other nine patients had combined anterior release or decompression and fusion combined with posterior instrumentation and spinal fusion. Bracing failed to halt the progressive kyphosis in those patients for whom it had been attempted. The only major complications in this series were two wound infections in patients previously treated with irradiation.
这是一项对1977年至1994年间由一位外科医生治疗的12例严重椎板切除术后和放疗后脊柱后凸患者的回顾性研究。患者的平均年龄为15岁，范围在2至35岁之间。随访时间从24个月到156个月不等，平均为65个月。所有患者均因椎管内病变或创伤接受了多级椎板切除术或胸腰椎放疗。术前平均脊柱后凸角度为84度，术后平均降至39度。未出现假关节形成，平均矫正丢失5度。无背痛主诉。3例中度严重但可活动的脊柱后凸患者接受了后路内固定和脊柱融合治疗。其他9例患者接受了前路松解或减压与融合联合后路内固定和脊柱融合治疗。对于尝试使用支具的患者，支具未能阻止脊柱后凸的进展。该系列中仅有的主要并发症是2例曾接受放疗患者的伤口感染。
