摘要
[目的]比较选择性前路或后路手术治疗Lenke5型青少年特发性脊柱侧凸未融合胸弯术后自发矫正情况。[方法]1997年5月～2005年10月，共72例接受手术的Lenke5型青少年特发性脊柱侧凸患者，其中40例采用选择性前路手术（A组），32例采用选择性后路手术（B组），随访时间最少2年。[结果]末次随访发现，两组患者无1例发生术后相关并发症，A组术前胸弯平均30°，术后平均16°；B组术前33°，术后18°。两组患者术后未融合胸弯大多得到了明显改善，且两组患改善率没有差别，但末次随访发现，72例患者中，4例患者（C组）术后胸弯加重，躯干发生了失平衡，A组、B组各2例。该4例患者（TL／L：T）Cobb’s比率均值为1．09，其余68例（D组）比率均值为1．59。C、D组患者胸弯柔韧性也有差别，C组较D组僵硬（分别34．2％和57．3％）．[结论]选择性前路或后路手术治疗Lenke5型青少年特发性脊柱侧凸，未融合胸弯自发矫正效果相当，但术前对患者（TL／L：T）Cobb’s比率和胸弯柔韧性进行评估非常重要。
[Objective] To compare sppntaneous correction of the unfused thoracic curves after selective anterior versus posterior fusion in Lenke5 adolescent idiopathic scoliosis （AIS） . [Method] A total of 72 Lenke5 AIS patients were reseruited from May 1997 to October 2005. Out of them, 40 received selective anterior fusion （group A） and 32 received selective posterior fusion （ group B ） . All had a minimum of 2 - year follow - up. [ Result ] No complication were found in both groups at the latest follow - up. The thoracic curve was corrected from 30° to 16° for group A, 33° to 18°for group B. Both grnups had a better spontaneous correction of the unfused thoracic curves. The correction rate had no significant difference between groups, However, the thoracic curve was increased in four patients （2 in each group; group C） , which resulted in trunk imbalance. The thoraeolumbar/lumbar thoracic （TL/L： T） Cobb＇s ratio averaged 1.09 in the four patients whereas 1.59 in other 68 patients （group D） . The flexihility of the thoracic curve had significant difference in group C and D （34. 2% vs 57. 3% ） . [ Conclusion] Both of the surgical treatments can get a better spontaneous correction of the unfused thoraeic curves. It is important to evaluate the. thoracolumbar/lumbar - thoracic （TL/L： T） Cobb＇s ratio and the flexibility of the thoracic curve before selective fusion.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2008年第21期1616-1618,共3页
Orthopedic Journal of China
