椎弓根螺钉和椎板钩选择性融合治疗胸椎青少年特发性脊柱侧弯的差异

被引:4
作者
付微平 [1 ]
张海鹰 [2 ]
楚戈 [3 ]
项泽文 [3 ]
王福忠 [4 ]
卢勇 [5 ]
机构
[1] 新疆生产建设兵团农九师医院骨科
[2] 新疆第一济困医院
[3] 新疆自治区中医医院脊柱一科
[4] 新疆麦盖提县医院外二科
[5] 新疆医科大学附属中医医院
关键词
特发性脊柱侧弯; 青少年; 椎弓根螺钉; 椎板钩; 后路选择性融合;
D O I
暂无
中图分类号
R687.3 [骨骼手术];
学科分类号
100220 [骨科学];
摘要
背景:既往的文献多报道用椎板钩或联合椎弓根螺钉治疗特发性脊柱侧弯或讨论融合节段的选择。目的:比较椎弓根螺钉和椎板钩治疗青少年特发性脊柱侧弯临床疗效的差异,并行影像学评价。方法:选择66例连续观察的青少年特发性脊柱侧弯(胸段主弯、腰段代偿弯)患者,均行后路内固定融合,末端融合到T12或L1椎体。其中32例行椎板钩内固定,34例行椎弓根螺钉内固定,内固定后最少随访2年。结果与结论:椎弓根螺钉组患者内固定后胸段Cobb角矫正程度及腰段Cobb角自发矫正程度明显大于椎板钩组(P<0.001)。椎板钩组内固定后13例患者冠状面朝左侧失代偿大于20mm(参照C7铅垂线),而椎弓根内固定组仅4例,差异有显著性意义(P<0.005)。两组患者均无并发症发生。提示后路选择性融合治疗特发性脊柱侧弯(胸段主弯、腰段代偿弯),与椎板钩相比,椎弓根螺钉有更好的矫正效果且内固定后冠状面失代偿发生率低。
引用
收藏
页码:4051 / 4055
页数:5
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