The analysis and complications of selective segmental pedjcle screws (SSPS) for the treatment treatment
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摘要:
目的分析后路选择性节段椎弓根螺钉固定治疗特发性脊柱侧凸的的临床疗效及并发症。 方法自2011年3月~2014年10月共行后路三维矫形术治疗52例青少年特发性脊柱侧凸患者，男20例，女32例；年龄13~18岁，平均16.5岁；52例患者均获得3~60个月的随访，平均随访30个月，统计手术并发症的发生情况。 结果术前冠状面主胸弯Cobb角分别为86.67°±10.31°（74.32°~96.5l°），手术时间为200.59±38.12 min，术中出血量838.10±197.90 mL，术后l周冠状面主胸弯畸形矫正率为（72.07±10.80）%，冠状面Cobb角平均残留21.37°±10.31°（11.32°~31.38°）；终末随访平均丢失21.37°±10.31°（11.32°~31.38°）；顶椎偏距平均残留2.37±1.25 cm，矫正率为（50.07±9.80）%，终末随访时平均丢失0.51±1.05 cm，丢失率为（8.07±3.11）%。4例中1例因侧凸进展而采用延长融合范围治疗；l例因近端交界后凸加剧而需向近端延长融合范围；1例感染患者接受了抗生素治疗；l例假关节形成患者采用更换断裂内固定及局部植骨治疗。 结论选择性节段椎弓根螺钉固定手术能有效改善AIS畸形，但存在相关并发症。 -
关键词:
- 青少年特发性脊柱侧凸 /
- 选择性节段 /
- 并发症
Abstract:Objective To evaluate the clinical value and complication of SSPS for adolescent idiopathic scoliosis (AIS). Methods From March 2011 to October 2014, a total of 52 patients underwent SSPS for AIS in our hospital. There were 20 males and 32 females, with a mean age of 16.5 years (range 13-18 years). The mean follow-up period was 30 months (range 3-60 months). The complications in intraoperative period and at early or long-middle term in post-operative period were observed. Results Cobb angle of major thoracic curve in standing comnal plane was 86.67°±10.31°(74.32°~96.5l°), flexibility was 15.82%±7.37%(6.82%~29.74%), operation timewas (200.59±38.12) min, blood loss during operation was (838.10±197.90) ml. correction rate of maior thomcic curve in comnal plane one week after operation were 72.07%±10.80%. Of 4 revision surgeries, fusion Segments were extended due to progressive scoliosis in 1 surgery; 1 patient underwent proximal fusion extension due to proximal junctional kyphosis; 1 patients had antibiotic therapy due to infection; 1 patient underwent implant replacement and autograft due to pseudarthrosis and instrument failure. Conclusion SSPS gain a good correction in the treatment of AIS. The most common causes for revision surgery for adolescent idiopathic scoliosis are curve progression, infection, pseudarthrosis and abnormal proximal junctional kyphosis. -
Key words:
- Adolescent idiopathic scoliosis /
- selective segmental /
- Complication
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