目的 初步探讨脊柱后路半椎体切除内固定术对低龄患儿脊柱畸形矫正的临床效果。方法 以2015年1月至2018年7月于复旦大学附属儿科医院接受后路半椎体切除术的低龄(<6岁)半椎体畸形患儿为研究对象,记录患儿手术时间、术中出血量、术后并发症等资料,通过影像学检查测量患儿术前、术后不同阶段的全脊柱矢状面改变情况、Cobb角、后凸角、后凸角修正值并进行统计分析。结果 本研究共纳入30例患儿,男19例,女11例,平均年龄(3.7±1.8)岁,术后平均随访时间(22.41±7.14)个月,平均手术时间(3.3±1.3)h,平均出血量(147.75±168.55)mL,患儿术后均无神经脊髓并发症发生,随访过程中出现2例因隐匿性椎弓根骨折造成的内置物相关并发症,经手术内固定翻修及延长固定节段后得到改善。患儿术后即刻以及末次随访Cobb角、后突角修正值术后均得到显著改善(P<0.05)。结论 采用脊柱后路半椎体切除经椎弓根钉短节段内固定融合术治疗低龄儿童的半椎体畸形安全、有效,但需基于精确的术前评估、严密的围手术期监护及完整的术后随访。
Objective To evaluate the efficacy of posterior hemivertebra resection on spinal deformity in young children. Methods From January 2015 to May 2018,retrospective reviews were conducted for 30 young children with hemivertebral deformities undergoing posterior hemivertebra resection and internal fixation.The data of operative duration,amount of bleeding and postoperative complications were recorded.The sagittal plane of whole spine,Cobb's angle,kyphotic Cobb's angle and correction values of kyphotic cobb's angle were measured by imaging data.And T test was used for comparing the effect of operation on correction of scoliosis and kyphosis. Results There were 19 boys and 11 girls with an average age of(3.7±1.8)years.The average follow-up period was(22.41±7.14)months,the average operative duration(3.3±1.3)h and the average amount of bleeding(147.74±168.55)mL.There was no postoperative onset of neurological and spinal complications.Two complications were associated with loosening of internal fixation in two children.The improvements of scoliosis and kyphosis were statistically significant. Conclusion Posterior hemivertebra resection is both safe and effective for correction of scoliosis and kyphosis caused by hemivertebra deformity in young children.
