电邮这篇文章 小儿重度特发性脊柱后凸侧弯的手术矫正研究
- 作者: Vissarionov S.V.1,2, Filippova A.N.1, Kokushin D.N.1, Murashko V.V.1, Belyanchikov S.M.1, Khusainov N.O.1
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隶属关系:
- The Turner Scientific Research Institute for Children’s Orthopedics
- Mechnikov North-Western State Medical University
- 期: 卷 7, 编号 3 (2019)
- 页面: 5-14
- 栏目: Original Study Article
- URL: https://journals.rcsi.science/turner/article/view/11679
- DOI: https://doi.org/10.17816/PTORS735-14
- ID: 11679
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详细
背景：经椎弓根金属混合结构的应用，已取得显著效果。但在重度特发性脊柱侧弯手术过程中，这些脊柱系统的植入有诸多限制。外科治疗策略考虑的不仅仅是术中矫正操作的表现，还有主要畸形椎弓顶部的活动度。松动性椎间盘切除术一般用于特发性脊柱侧弯患者顶椎。经椎弓根截骨术、Ponte截骨术、Smith-Petersen截骨术最常用于治疗神经肌肉性脊柱侧弯和以脊柱后凸为主的脊柱畸形。但对于小儿“被忽视”的脊柱疾病和特发性脊柱侧弯，手术矫正依然存在问题。
目的：本研究旨在对小儿极重度特发性右侧胸椎侧弯的两种脊柱畸形矫正方法进行对比分析，即单用经椎弓根脊柱系统和联用顶椎楔形截骨术。
材料和方法：对20例15至17岁极重度特发性右侧胸椎后凸侧弯患儿的手术治疗结果进行分析。所有患者接受了标准术前检查，包括放射学检查、计算机断层扫描、核磁共振成像和神经生物学检查。根据手术第二阶段采用的方法，将患者分为两组；在手术第二阶段，（1）单用经椎弓根系统或（2）联合顶椎楔形截骨术来矫正畸形。
结果和讨论：第一组患者脊柱侧弯和脊柱后凸的矫正水平分别为25%至62%、21%至56%。对于术中联合顶椎楔形截骨术的第二组患者，脊柱侧弯和脊柱后凸的矫正水平分别为36%至74%、50%至70%。
结论：对于特发性胸椎后凸侧弯患儿而言，顶椎楔形椎体次全切是另外一种有效的松动术，能够明显矫正脊柱侧弯和脊柱后凸，在术中可以恢复脊柱的生理学功能和躯体平衡，在长期观察期内也能维持理想的效果。
作者简介
Sergey Vissarionov
The Turner Scientific Research Institute for Children’s Orthopedics; Mechnikov North-Western State Medical University
编辑信件的主要联系方式.
Email: vissarionovs@gmail.com
ORCID iD: 0000-0003-4235-5048
MD, PhD, D.Sc., Professor, Deputy Director for Research and Academic Affairs, Head of the Department of Spinal Pathology and Neurosurgery; Professor of the Chair of Pediatric Traumatology and Orthopedics
俄罗斯联邦, Saint PetersburgAleksandra Filippova
The Turner Scientific Research Institute for Children’s Orthopedics
Email: alexandrjonok@mail.ru
ORCID iD: 0000-0001-9586-0668
MD, PhD Student of the Department of Spine Pathology and Neurosurgery
俄罗斯联邦, Saint PetersburgDmitriy Kokushin
The Turner Scientific Research Institute for Children’s Orthopedics
Email: partgerm@yandex.ru
ORCID iD: 0000-0002-2510-7213
MD, PhD, Senior Research Associate of the Department of Pathology of the Spine and Neurosurgery
俄罗斯联邦, Saint PetersburgVladislav Murashko
The Turner Scientific Research Institute for Children’s Orthopedics
Email: partgerm@yandex.ru
ORCID iD: 0000-0002-2201-6906
MD, Orthopedic and Trauma Surgeon of the Department of Spine Pathology and Neurosurgery
俄罗斯联邦, Saint PetersburgSergei Belyanchikov
The Turner Scientific Research Institute for Children’s Orthopedics
Email: beljanchikov@list.ru
ORCID iD: 0000-0002-7464-1244
MD, PhD, Orthopedic and Trauma Surgeon, Head of the Department of Pathology of the Spine and Neurosurgery
俄罗斯联邦, Saint PetersburgNikita Khusainov
The Turner Scientific Research Institute for Children’s Orthopedics
Email: nikita_husainov@mail.ru
ORCID iD: 0000-0003-3036-3796
MD, PhD, Research Associate of the Department of Pathology of the Spine and Neurosurgery
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