小儿脊柱侧弯的微创前路脊柱显露与松解
Minimally invasive anterior spinal exposure and release in children with scoliosis.
作者信息
Kokoska E R, Gabriel K R, Silen M L
机构信息
Department of Surgery, Saint Louis University Health Sciences Center, MO, USA.
出版信息
JSLS. 1998 Jul-Sep;2(3):255-8.
BACKGROUND
The early experience with thoracoscopy in children has involved the diagnosis and treatment of pleural and pulmonary diseases. Recent advances have allowed surgeons to perform more complex procedures through video-assisted thoracoscopic surgery (VATS), potentially decreasing the pain and pulmonary impairment associated with an open thoracotomy. The authors report their initial experience with thoracoscopic assisted anterior spinal exposure and release as part of the treatment for children with spinal deformities.
METHODS
A retrospective chart review of five children who underwent VATS for anterior spinal surgery between June 1995 and January 1997 was performed.
RESULTS
The ages of the patients ranged from 11 to 16 years with a mean of 13.4 years. All patients had an anterior spinal release with or without fusion and same-day posterior spinal fusion with instrumentation. VATS was successfully completed in all patients without major morbidity and no mortality. The average operative time for the anterior portion of the procedure was 305 minutes, and a mean of 7 disc levels were released. Mean length of chest tube drainage and hospitalization were 6.8 and 8.6 days, respectively.
CONCLUSIONS
The objectives of anterior exposure for spinal surgery in children can safely and effectively be accomplished using minimally invasive surgery.
背景
儿童胸腔镜的早期应用主要涉及胸膜和肺部疾病的诊断与治疗。近年来的进展使外科医生能够通过电视辅助胸腔镜手术（VATS）开展更复杂的手术，这有可能减轻与开胸手术相关的疼痛和肺损伤。作者报告了他们在胸腔镜辅助下进行前路脊柱显露和松解作为治疗儿童脊柱畸形一部分的初步经验。
方法
对1995年6月至1997年1月间接受VATS前路脊柱手术的5名儿童进行回顾性病历审查。
结果
患者年龄在11至16岁之间，平均13.4岁。所有患者均接受了前路脊柱松解，可伴有或不伴有融合，并在同一天进行后路脊柱融合及内固定。所有患者VATS均成功完成，无严重并发症，无死亡病例。手术前部的平均手术时间为305分钟，平均松解7个椎间盘节段。胸腔闭式引流平均时间和住院时间分别为6.8天和8.6天。
结论
采用微创手术能够安全有效地实现儿童脊柱手术前路显露的目标。
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