后路交叉置钉技术在青少年脊柱侧凸治疗中的应用
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- 摘要:
- ?目的探讨后路交叉置钉技术对于治疗青少年脊柱侧凸的临床疗效。方法2010年1月至2014年1月，68例青少年脊柱侧凸病例，男10例，女58例，年龄11～16岁，平均135岁；其中4例为神经肌肉型脊柱侧凸，其余为特发性脊柱侧凸；术前冠状面主弯Cobb角平均562°，胸椎（T5～T12）后凸角度平均177°，手术方法为后路交叉置入椎弓根螺钉对脊柱侧凸进行矫正，对术后Cobb角、主弯Cobb角矫正率结果进行评价。结果术后随访12 ～ 40个月，平均225个月。术后主弯Cobb角矫正到185°，与术前比较有差异（t=3705，P<001），末次随访时平均202°，与术后比无差异（t=1053，P>005）。胸椎（T5～T12）后凸角术后平均228°，末次随访时平均232°，术前与术后、术后与末次随访相比较均无差异（P>005）。术后主弯Cobb角矫正率为705%，而末次随访时虽然主弯矫正率（694%）有一定丢失，但和术后比较无差异（t=0126，P>005）。术后无患者出现脊髓或神经根损伤。末次随访时无内固定松动及断钉断棒，植骨融合牢固，均未出现明显的矫正丢失。结论对于青少年脊柱侧凸后路手术矫正，采用交叉置钉技术是一项值得推广的低费用、高安全的脊柱侧凸矫正技术。
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