Guo Dong,Gao Rongxuan,Yao Ziming,et al.One-stage posterior-only lumbosacral hemivertebra resection with short-segment internal fixation and fusion in children[J].Journal of Clinical Pediatric Surgery,,19():596-602.[doi:10.3969/j.issn.1671-6353.2020.07.007]
One-stage posterior-only lumbosacral hemivertebra resection with short-segment internal fixation and fusion in children
- Keywords:
- Scoliosis/SU; Lumbosacral Region; Treatment Outcome; Child
- CLC:
- R726.8;R681.5+7
- Abstract:
- Objective To evaluate the surgical outcomes of one-stage posterior-only lumbosacral hemivertebra resection with short-segment internal fixation and fusion in children.Methods This retrospective reviews were conducted for the clinical data of 21 congenital scoliosis children with lumbosacral hemivertebra undergoing one-stage posterior-only hemivertebra resection with short-segment internal fixation and fusion,with at least a 24-month follow-up,from Jun 2014 to Dec 2017.Standing anteroposterior and lateral radiographs of full spine were acquired and compared pre-operatively,post-operatively and at the last follow-up.Radiographic evaluation included measured changes in segmental scoliosis and lordosis,compensatory scoliosis,thoracic kyphosis,lumbar lordosis,trunk shift,sagittal vertical axis,pelvic incidence,pelvic tilt and sacral slope.Results There are 12 boys and 9 girls with an average age of 6.50±3.22(2.17~13.00)years.The mean follow-up period was 48.10±17.72(24~84) months.The mean fusion level was 2.67±0.91(2~4) segments.Mean operation time was 168.57±46.18(120~300)min with the average blood loss of 368.04±234.58(100~1 000)mL.The mean segmental scoliosis was 28.9±6.3°preoperatively,8.5±3.0° (correction rate of 70.6%) postoperatively,and 7.0±3.4°(correction rate of 75.8%) at the latest follow-up.The compensatory coronal curve of 25.8±11.7° was spontaneously corrected to 13.7±8.3°(correction rate of 46.9%) at most recent follow-up.Trunk shift was significantly improved on both coronal (53.1%) and sagittal (56.3%) plane after surgery,and kept stable during the follow-up.The sagittal pelvic was balanced in all cases.There were no neurologic and infectious complications.Conclusion One-stage posterior-only lumbosacral hemivertebra resection with short-segment internal fixation and fusion in children can offer excellent scoliosis correction and trunk shift improvement,while saving motion segments as much as possible.This strategy is not only corrective of the deformity but also preventive of compensatory curve progression,thus avoiding long lumbar fusion.
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Memo
收稿日期:2019-05-26。
基金项目:国家重点研发计划（编号：2016YFC1000806）
通讯作者:张学军,Email:zhang-x-j04@163.com