头盆环牵引全脊柱截骨内固定治疗重度脊柱弯曲.doc

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1、头盆环牵引全脊柱截骨内固定治疗重度脊柱弯曲【摘要】［目的］介绍头盆环牵引全脊柱截骨加内定治疗重度脊柱弯曲的手术方法，并总结185例重度脊柱弯曲的治疗结果。［方法］对重度脊柱侧弯患者，先用头盆环牵引，使重弯变为轻弯，以便置入器械的安装，再在头盆环牵引下进行截骨矫正畸形和内固定手术，术后继续配戴头盆环制动，术后第2d即可下床站立活动，给护理工作带来极大方便。［结果］作者自1983〜n年，采用此法治疗重度脊柱侧弯185例，平均矫正率是％。脊柱截骨断端能迗到坚固的骨性融合，矫正率丢失平均在5°以内，术后晚期并发脱钩者4例，均经再次手术固定解决，对矫正效果无影

2、响。1例术后1年并发感染，拆除置入器械后，伤口很快愈合，X线所见植骨愈合良好。1例并发神经根疼痛，而后逐渐减轻，所有病例未见脊髓损伤和神经系统并发症发生。［结论］头盆环牵引加全脊柱截骨是治疗重度脊柱侧弯的有效方法，对那些仅用单纯器械无法安装，置入困难的病例，经头盆环牵引后，内固定器械容易安装，再加上全脊柱截骨，能使弯曲的脊柱进一步伸直，减轻了内固定器械所承受的负荷力，避免了脱钩断棍的发生，为治疗重度脊柱侧弯的有效手段。【关键词】重度脊柱侧弯头盆环牵引全脊柱截骨术Halopelvicdistractionincombinationwithtotalsp

3、ineosteotomyandinternalfixationfortreatmentofseverescoliosisAbstract：[Objective]Toreporttherecordsof185patientsinwhomseverescoliosishadbeentreatedwithpreoperativehalopelvicdistractionandfollowingtotalspineosteotomyandinternalfixation.[Method]Preoperativehalopelvicdistractionwas

4、appliedtoallpatientstoreducetheseverityofcurvaturesandmakethefollowingtreatmentpossible.Thentotalspineosteotomyandinternalfixationwereperformedtorectifytheremaineddeformityofthepelvicdistractionwasmaintainedduringtheoperationandpostoperativelytolimitthemobilizationoftheonedayaf

5、tertheoperation,thepatientswereabletogetoutofbed,standupandmovearound,makingnursingcaremoreconvenient.[Result]Betweenl983andXX,atotalof185casesofseverescoliosisweretreatedbythisapproachandanaveragecorrectionrateof%wasbonefusionswereachievedatthecutendsofthcaveragelossofcorrecti

6、onratewaslessthan5thelatestageofpostoperativeduration,rodreleaseoccurredinfourcasesandwasresolvedbysecondsurgicalintervention,showingnoadverseeffectontheelinicaloneyearpostoperativeinfectivecomplicationoccurredinonecaseandthepatientfullyrecoveredaftertheremovaloftheinsertedraye

7、xaminationconfirmedgoodhealingofthehonepainoccurredinonecaseandthepatientgraduallyrecoveredwithoutanymedicaloftherestpatientshadevidenceofspinalcordornervoussystemcomplications.[Conclusion]Halopelvicdistractioninstrumenation,incombinationwithtotalspineosteotomy,isaneffectivetre

8、atmentmodalityforseverespinalpelvicdistractioncanfacil