摘要
目的:探讨电视辅助胸腔镜下脊柱侧凸矫形融合术的操作技术和初期临床结果。方法:回顾性分析我院2003年3月至2004年1月完成的10例胸腔镜下Eclipse矫形融合术病例,特发性脊柱侧凸9例,先天性脊柱侧凸1例,年龄11￣17岁,平均13.3岁。对手术前后及随访时冠状面和矢状面Cobb角进行测量,并对手术时间、术中出血量、围手术期并发症及初步矫形效果进行分析。结果:手术时间平均6.5h,固定融合节段5￣7个(平均6.3个)椎体,每一节段手术时间0.75￣1.70h(平均1.1h),手术总失血量200～600ml(平均360ml)。手术前后主胸弯冠状面Cobb角分别为44.0°和16.4°,手术矫形率63.2%;手术前后腰弯冠状面Cobb角分别为29.0°和12.9°,自动矫形率54.4%。随访6￣24个月,平均14.7月,随访时胸、腰弯冠状面Cobb角分别为20.1°和19.6°,分别丢失3.7°和6.7°。手术前后主胸弯的顶椎偏距分别为28.6mm和9.6mm,腰弯的顶椎偏距分别为14.1mm和8.6mm。手术前后矢状面上胸后凸的Cobb角分别为12.3°和23.9°。结论:电视辅助胸腔镜下脊柱侧凸矫形融合术具有创伤小,出血少和小切口美容效果,对轻中度侧凸可获得良好矫形效果,但矫形容易丢失。
Objective：To evaluate the operative technique and preliminary results of thoracoscopic anterior correction and fusion of scoliosis.Method：Ten cases undergoing thoracoscopic anterior correction and fusion of scoliosis form March 2003 to Januray 2004 were reviewed.9 cases were idiopathic scoliosis and l case of congenital scoliosis with an average age of 13.3 years old.The coronal and sagittal Cobb angle,trunk shift,and apical vertebral translation before and after surgery,and at final follow-up were measured,the operation time, intraoperational blood loss volumn,peri-operative complications were documented.Result：The mean operation time was 6.5 hours,the mean number of instrumented vertebrae were 6.3 segments,the mean intraoperational blood loss volumn was 360ml.The coronal Cobb angle of the thoracic curve before and after surgery were 44.0° and 16.4° respectively,with a mean correction rate of 63.2%.The lumbar curve was 29.0° of preoperation and of postoperation 2.9° with a mean simultaneous correction rate of 54.4%.At the final follow-up,the coronal Cobb angle of the thoracic and lumbar curve were 20.1° and 19.6°,with a 3.7°and 6.7° loss of correction respectively.The apical vertebral translation was improved from 28.6mm to 9.6mm for the thoracic curve,and 14.1mm and 8.6mm for the lumbar curve.In the sagittal plane,a preoperative 12.3°of thoracic kyphosis was improved to 23.9° within a normal range.Conclusion：Anterior thoracoscopic correction and fusion of scoliosis had a good correction potention,less intraoperative bleeding and cosmetic effect for mild and moderate thoracic scoliosis,but had a relatively higher loss of correction.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2006年第3期187-191,共5页
Chinese Journal of Spine and Spinal Cord
