摘要
[目的]观察经胸腔镜前路松解后路矫形一期治疗僵硬性脊柱侧弯的效果。临床资料：共10例特发性脊柱侧弯（King116例，KingⅢ3例，KingⅣ1例）。男6例，女4例；年龄14～2l岁，平均17．2岁。冠状面Cobb’s角67°～125°（平均91．9°），胸椎侧凸柔软度为19．30％～36．5％（平均28．3％）。[方法]全麻下（单或双肺通气）侧卧位胸腔镜下以顶椎为中心做5～6个椎间盘及纤维环的切除达到松解植骨，术毕改俯卧位行后路三维矫形术。[结果]本组患者均前路成功松解胸椎，手术时间120～150min，术中出血量100～200ml（平均151m1），术后引流量100～150ml；同期行后路器械矫形；术后Cobb’s角为26°～75°（平均47°），侧弯矫正率51．5％。患者切口Ⅰ／甲愈合。无气胸、呼吸道梗阻、肺部感染以及神经系统并发症。经6～12个月随访，植骨均已融合。无矫形度的丢失及内固定并发症；外形改善明显。[结论]经胸腔镜前路松解后路矫形一期治疗僵硬性脊柱侧弯可有效提高手术效果，有很好的安全性，减少手术次数。
[Objective] To evaluate the safety and efficacy of the surgery, which was done by a video-assisted thoraeoscope to release the anteriorroute part of spine and done by posterior instrumented fusion with severe Adolescent Idiopathic Scoliosis （AIS）. Clinic date： There were 10 cases of AIS （King Ⅱ 6, King Ⅲ 3, King Ⅳ 1 ） , in which there were 6 males and 4 females. The average age was 17.2 years （ range 14 - 21 ）. The average preoperative primary curve in the coronal plane was 91.3° （ ranged 67° - 125° ） and the average pliability of thoracic spine was 28.3% （ ranged 19.3% - 36. 5% ）. [ Method] With general anesthesia （ one-lung ventilation or two-lung ventilation） , the disc complexes and part of the anterior longitudinal ligament of 5 - 6 disc near apex vertebra were excised under endoscopic visualization. In the same operation, the posterior instrumented fusion was done. [ Result] The anterior releases under endoscopic visualization needed 120 - 150 min with average bleeding 157ml （ranged 100 -200 ml）. The thoracic draining was 100 - 150 ml After the posterior route surgery, the average coronal Cobb＇s angle was 47° （ranged 26° -75°） and the rate of rectification was 51.5%. The patients had good fusion and outlook without other complications. [ Conclusion] This way, which is done by a videoassisted thoracoscope to release the anterior part of spine and done by posterior instrumented fusion has a good result about safety and efficacy.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2006年第11期805-807,共3页
Orthopedic Journal of China
关键词
胸腔镜
脊柱畸形
脊柱侧弯
Thoracoscope
Spinal abnormility
Scoliosis
