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[目的]观察6岁以下儿童后路半椎体切除短节段固定的安全性及疗效。[方法]回顾性分析2009年2月~2014年12月接受后路半椎体切除短节段固定的脊柱侧后凸患儿31例。其中男15例,女16例;年龄1岁11个月~5岁5个月,平均3岁9个月。记录手术时间,术中出血量,术前、术后及末次随访影像学的改变。通过文献复习,从而评价手术效果及安全性。[结果]手术时间133~288 min,平均手术时间157 min。出血量50~600 ml,平均324.5 ml。术后2周冠状面及矢状面主弯Cobb角分别为2°~25°及13°~20°,平均矫形率分别为67.8%、50.1%,与术前比较差异具有统计学意义(P<0.05)。术后所有病例均获得随访,随访时间11~48个月,平均23个月。末次随访冠状面及矢状面主弯Cobb角,与术后2周比较差异无统计学意义(P>0.05)。所有患者随访期间恢复良好,无其他神经系统并发症及感染,内固定无断钉及松动,矫正度无显著丢失。[结论]先天性脊柱侧后凸采用后路半椎体切除是控制畸形进展的有效方式。尽可能早地选择手术,可获得冠状面和矢状面良好的矫正效果、低神经损伤风险,可避免手术节段延长。
[Objective] To observe the safety and efficacy of posterior hemivertebra resection in short segment fixation of children younger than 6 years old. [Methods] A retrospective analysis of 31 cases of children with kyphosis who underwent posterior hemivertebra resection and short segment fixation from February 2009 to December 2014 was retrospectively analyzed. Including 15 males and 16 females; aged 1 year and 11 months to 5 years and 5 months, an average of 3 years and 9 months. The operation time, intraoperative blood loss, preoperative, postoperative and final follow-up imaging changes were recorded. Through literature review, to evaluate the effect and safety of surgery. [Result] The operation time ranged from 133 to 288 min with an average operation time of 157 min. Bleeding volume 50 ~ 600 ml, an average of 324.5 ml. The Cobb angles of the coronal and sagittal planes at 2 weeks postoperatively ranged from 2 ° to 25 ° and from 13 ° to 20 °, respectively. The mean correction rates were 67.8% and 50.1%, respectively, with statistical significance (P <0.05). All cases were followed up for 11-48 months with an average of 23 months. There was no significant difference in the Cobb angle of the main curve between the coronal and sagittal planes at the last follow-up (P> 0.05). All patients recovered well during follow-up, no other complications and infection of the nervous system, no broken screws and loose fixation, no significant loss of correction. [Conclusion] Posterior hemivertebra resection using congenital kyphoscoliosis is an effective way to control the progression of deformity. Choose the surgery as early as possible to achieve good correction of the coronal and sagittal planes, a low risk of neurological injury, and the avoidance of extended surgical segments.