论文部分内容阅读
目的探讨早发的儿童严重脊柱侧凸采用生长阀双棒内固定治疗的临床疗效。方法选择2006年11月~2011年3月我科收治入院的早发的严重脊柱侧凸儿童10例临床资料进行回顾性分析,10例患儿中9例采用lsola生长阀固定,1例采用TSRH生长阀固定;撑开1~4次,平均1.8次;随访10~24个月,平均(15.2±2.5)个月。结果术前主弯Cobb角(67.64±11.43)°,胸后凸(31.00±22.40)°,躯干偏移(2.00±1.43)cm,T1~S1高度(25.47±6.16)cm;初次术后主弯Cobb角(34.64±8.26)°,胸后凸(23.00±8.06)°,躯干偏移(1.49±1.21)cm,T1~S1高度(28.84±5.69)cm;末次术后主弯Cobb角(36.82±11.76)°,胸后凸(27.18±8.97)°,躯干偏移(1.11±0.29)cm,T1~S1高度(31.29±4.50)cm。术前、初次术后和末次术后主弯侧凸角比较差异有统计学意义(P<0.05)。初次手术矫正率(47.15±16.48)%,T1~S1高度增加(3.37±1.62)cm;末次手术矫正率(44.73±19.43)%,T1~S1高度增加(5.82±2.21)cm。治疗期间T1~S1每年平均生长1.6 cm(1.1~2.7 cm)。5例出现并发症(3例脱钩,1例椎弓根螺钉脱出,1例断棒)。结论生长阀双棒内固定技术允许脊柱纵向生长,同时起到矫形和控制畸形发展的作用,但术后并发症发生率较高。
Objective To investigate the clinical efficacy of double rod internal fixation with growth valve in children with severe scoliosis. Methods From November 2006 to March 2011, 10 cases of early-onset severe scoliosis in our hospital were retrospectively analyzed. Nine of 10 children were fixed with lsola growth valve, and one case was treated with TSRH Growth valve fixed; distraction 1 to 4 times, an average of 1.8 times; 10 to 24 months follow-up, with an average (15.2 ± 2.5) months. Results The mean preoperative Cobb angle (67.64 ± 11.43) °, Thoracic kyphosis (31.00 ± 22.40 °), Torsion offset (2.00 ± 1.43) cm and T1 ~ S1 height (25.47 ± 6.16) cm were significantly different between the two groups Cobb angle (34.64 ± 8.26) °, thoracic kyphosis (23.00 ± 8.06) °, trunk deviation (1.49 ± 1.21) cm and T1 ~ S1 height (28.84 ± 5.69) cm. Cobb angle 11.76) °, thoracic kyphosis (27.18 ± 8.97) °, trunk deviation (1.11 ± 0.29) cm, and T1 ~ S1 height (31.29 ± 4.50) cm. The preoperative, primary and postoperative primary lobe angle were significantly different (P <0.05). The initial surgical correction rate was (47.15 ± 16.48)%, the height of T1 ~ S1 was increased (3.37 ± 1.62) cm, the final surgical correction rate was 44.73 ± 19.43%, and the height of T1 ~ S1 was increased (5.82 ± 2.21) cm. T1 ~ S1 during treatment average annual growth of 1.6 cm (1.1 ~ 2.7 cm). Complications occurred in 5 cases (3 cases of decoupling, 1 case of pedicle screw prolapse and 1 case of broken bar). CONCLUSIONS: The dual rod fixation with growth valve allows longitudinal growth of the spine and plays an important role in orthopedic and deformity control. However, the incidence of postoperative complications is high.