|
Objective To explore a posterior vertebral resection , half of the screw rod system orthopedic , bone grafting and internal fixation for the treatment spine due to congenital spinal deformity feasibility and efficacy . Methods From May 2004 to December 2008 , 28 cases due to congenital spinal vertebral kyphoscoliosis with a posterior vertebral resection , screw rod system orthopedic bone fusion and internal fixation . 13 males and 15 females , aged 4 to 16 years old, with an average of 11.4 years . The single vertebral 17 cases , two-and-a-half spine in nine cases , more than half spine two cases , vertebral merger contralateral osteopontin or rib fusion , merger diastematomyelia four cases , and spinal cord tethered two cases , the combined nerve fibers fibromatosis two cases , combined thoracic syringomyelia cases with spinal teratoma , congenital heart disease patients . 15 cases of lesions in the thoracic , located in the thoracolumbar six cases , located lumbar seven cases . Preoperative coronal Cobb's angle 44.38 ± 21.02 ° (10 ° to 110 ° ) , sagittal Cobb's angle 64.80 ± 22.24 ° (27 ° to 95 ° ) , which simply kyphosis two cases , Cobb's angle were 43 °, 80 °, scoliosis accompanied kyphosis 13 cases . Results The operation time was 175 ~ 405min, average 279.6min; blood loss 400 ~~ 2000ml , 1046ml average . The fixed fusion segments 3 to 12 vertebrae, an average of 6.9 . Intraoperative pleural rupture three cases , direct suture or soft tissue filling closed , does not appear after hemopneumothorax complications ; 2 cases of postoperative paralysis of the lower limbs , including cases of spinal hematoma around , after the second surgery to remove the hematoma muscle force and feeling gradually better, other cases were treated conservatively three months to return to normal . Were followed up for 1 to 4 years , 5 months , an average of 2 January . Postoperative coronal Cobb's angle was 11.00 ± 9.08 ° (0 ° to 31 ° ) , the correction rate of 75 % ; final follow-up was 11.62 ± 9.55 ° (0 ° to 31 °) , the correction rate of 73.9% . Sagittal Cobb's angle 28.33 ± 12.54 ° (10 ° to 70 ° ) , the correction rate of 56.3% . Last follow-up sagittal Cobb's angle 29.13 ± 15.41 ° (10 ° to 67 °) , the correction rate of 55 % . During follow-up , there were two cases of titanium mesh cutting vertebral , cases of internal fixation screws loose causing the loss of orthopedic angle , and the remaining patients had no pseudarthrosis , internal fixation devices loosening , fracture , torso , loss of balance and other complications . Conclusion a posterior vertebral resection , screw rod system orthopedic , bone grafting and internal fixation for the treatment half spine due to congenital kyphoscoliosis satisfactory result , effective and reliable .
|