儿童角型后凸的前路矫正:技术描述及临床资料分析

Q3 Medicine Hirurgia Pozvonochnika Pub Date : 2018-12-04 DOI:10.14531/2018.4.15-20
A. Mushkin, D. Naumov, V. Zorin, M. Serdobintsev
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引用次数: 0

摘要

目标。描述一种简化儿童脊柱前柱工具性牵张后凸矫正的原始技术手术方法,并分析其在临床系列设置中的有效性。证据水平- IV.材料和方法。该研究纳入9例患者,年龄7个月至14岁(中位年龄:4年8个月),伴有结核性脊柱炎(n = 4)和非特异性脊柱炎(n = 4)以及脊髓损伤后遗症(n = 1)的角型后凸(中位角53°,最小角- 38°,最大角- 80°)。在单步两阶段重建和稳定手术中,采用临时器械椎间撑开,然后用钛网笼填充自体骨移植物进行前路融合,实现了畸形矫正。结果。手术时间为3小时2分钟±44分钟,失血量- 190毫升±39毫升。所有病例的畸形矫正率为75 - 85%,恢复了生理性胸后凸和脊柱轮廓。结论。一种安全有效的术中前路器械牵张技术可用于矫正儿童(包括婴儿)的角型后凸。
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Anterior correction of angular kyphosis in children: description of the technique and analysis of clinical series
Objective. To describe the original technical surgical procedure simplifying the correction of kyphosis in children due to instrumental distraction of the anterior column of the spine, to analyze its effectiveness in the setting of clinical series. Level of evidence – IV. Material and Methods. The study included 9 patients aged 7 months to 14 years (median age: 4 years 8 months) with angular kyphosis (median magnitude 53°, min – 38°, max – 80°) associated with tuberculous (n = 4) and non-specific (n = 4) spondylitis and with a sequelae of spinal cord injury (n = 1). Deformity correction was achieved using temporary instrumental interbody distraction followed by anterior fusion with titanium mesh cage filled with autologous bone graft during a single-step two-stage reconstruction and stabilization surgery. Results. The duration of surgery was 3 hours 2 min ± 44 min, the volume of blood loss – 190 ml ± 39 ml. In all cases, the deformity was corrected by 75–85 % with restoration of physiological thoracic kyphosis and spinal profile. Conclusion. A safe and effective technique for intraoperative anterior instrumental distraction can be used to correct angular kyphosis in children, including infants.
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来源期刊
Hirurgia Pozvonochnika
Hirurgia Pozvonochnika Medicine-Anesthesiology and Pain Medicine
CiteScore
0.60
自引率
0.00%
发文量
24
审稿时长
7 weeks
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