多平面截骨矫形骨水泥强化椎弓根钉内固定治疗骨质疏松性脊柱后凸畸形
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摘要
目的观察多平面Smith-Petersen截骨矫形骨水泥强化椎弓根钉内固定治疗骨质疏松性脊柱后凸畸形的临床疗效,评价其可行性、有效性及安全性。方法回顾性分析自2010-01—2013-01采用多平面Smith-Petersen截骨矫形骨水泥强化椎弓根钉内固定治疗的23例骨质疏松性脊柱后凸畸形。疗效采用Stauffer-Coventry标准评定。结果 23例均顺利完成手术并至少随访3年。术后3年疼痛VAS评分、ODI指数、JOA评分、Cobb角、SVA均较术前明显改善,差异有统计学意义(P <0.05)。末次随访时疗效采用Stauffer-Coventry标准评定:优15例,良5例,可2例,差1例。结论多平面Smith-Petersen截骨矫形骨水泥强化椎弓根钉内固定治疗骨质疏松性脊柱后凸畸形安全有效,该术式可以缓解患者临床症状,解决骨质疏松椎体难以固定的问题,能够良好矫正脊柱矢状面平衡,进而达到矫正后凸畸形的目的。
引文
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[12]袁华澄,游戊已,林晓毅,等.Smith-Peterson截骨术治疗退行性腰椎侧凸畸形[J].中国矫形外科杂志,2010,18(9):721-724.
[2]刘磊.高粘度骨水泥椎体后凸成形术在骨质疏松性椎体压缩骨折中的应用及疗效观察[D].南京:南京中医药大学,2016.
[3]Ataka H,Tanno T,Yamazaki M.Posterior instrumented fusion without neural decompression for incomplete neurological deficits following vertebral collapse in the osteoporotic thoracolumbar spine[J].Eur Spine J,2009,18(1):69-76.
[4]郝定均,刘鹏,贺宝荣,等.陈旧性与新鲜性压缩骨折行椎体成形术的临床对比研究[J].脊柱外科杂志,2012,10(2):83-86.
[5]韩猛,刘磊,刘光旺,等.后路椎板切除截骨矫形内固定治疗骨质疏松性胸腰段后凸畸形的疗效观察[J].中国骨与关节损伤杂志,2017,32(9):909-912.
[6]徐冠华,崔志明,李卫东,等.后路截骨矫形手术治疗老年骨质疏松性陈旧胸腰椎骨折伴后凸畸形[J].中国脊柱脊髓杂志,2013,23(2):129-134.
[7]Bridwell KH.Decision making regarding Smith-Petersen vs.pedicle subtraction osteotomy vs.vertebral column resection for spinal deformity[J].Spine(Phila Pa 1976),2006,31(19 Suppl):S171-178.
[8]刘新宇,郑燕平,李建民,等.脊椎截骨后脊柱短缩安全范围的实验研究[J].中华骨科杂志,2009,29(5):503-507.
[9]宋林章,陈令斌.脊柱后路截骨术治疗局部严重后凸畸形的研究进展[J].脊柱外科杂志,2016,14(2):121-124.
[10]Tan JS,Bailey CS,Dvorak MF,et al.Cement augmentation of vertebral screws enhances the interface strength between interbody device and vertebral body[J].Spine(Phila Pa 1976),2007,32(3):334-341.
[11]李放,张志成,孙天胜,等.单节段“蛋壳”式椎体截骨术矫正胸腰段脊柱后凸畸形[J].脊柱外科杂志,2007,5(6):342-345.
[12]袁华澄,游戊已,林晓毅,等.Smith-Peterson截骨术治疗退行性腰椎侧凸畸形[J].中国矫形外科杂志,2010,18(9):721-724.