·临床研究·2012年10月第9卷第30期
中国医药导报CHINA MEDICAL HERALD [作者简介]马斌（1970.10-），男，本科，主任，副院长；研究方向：骨科。先天性脊柱侧凸分为椎体形成缺陷（Ⅰ型）、分节缺
陷（Ⅱ型）和混合型（Ⅲ型）三类，Ⅰ型包括半椎体（完全
性）和楔形椎体（部分性）。其中半椎体是指一侧椎体发育
形成障碍而起的畸形。半椎体畸形是先天性脊柱侧凸最
常见的原因，所致脊柱侧凸约占先天性脊柱侧凸46%[1]。
心灵成长
由于完全分节的半椎体具有正常的生长能力，所以产生的畸形具有进展性，常发展为重度僵硬性侧后凸畸形，给手术治疗带来困难。笔者2006年7月～2011年10月收治的先天性胸腰段半椎体并重度僵硬性脊柱侧后凸畸形患者10例，均行经后路松解楔形截骨矫形手术治疗，现总结如下：
先天性胸腰段半椎体并重度僵硬性脊柱侧后凸
畸形的后路松解楔形截骨矫治
营销数据
耻骨图片戴冲华马斌
云南省陆良县人民医院骨科，云南陆良655600
笔记本屏幕暗[摘要]目的探讨先天性胸腰段半椎体并重度僵硬性脊柱侧后凸畸形患者采用经后路松解楔形截骨治疗的安全性和临床初步效果，并探讨其融合固定节段（LIV ）的选择。方法选择我院2006年7月～2011年10月收治的先天性胸腰段半椎体并重度僵硬性脊柱侧后凸畸形患者10例临床资料，均行经后路松解楔形截骨矫形手术，以触及椎（touched vertebrae ，TV ）（指站立前后位像上被骶正中线触及的最近端椎体）作为融合固定下端椎。结果本组10例患者均顺利完成手术。平均松解3.0个椎间隙；手术时间4.5～9.4h ，平均6.3h ；术中出血量680～10000mL ，平均985mL ；术后侧凸Cobb 角6°～32°，平均18.7°，平均矫正率为27.2%；后凸Cobb 角-8°～22°，平均8.3°，平均矫正率为88.6%；C 7铅垂线与骶正中线距离0.1～2.3cm ，平均0.6cm ，冠状位平衡平均矫正率为78.1%。随访14～35个月，平均23.4个月，末次随访侧凸Cobb 角8°～57°，平均29.7°，丢失率为7.3%；后凸Cobb 角22°～38°，平均29.9°，丢失率为
鸡蛋饼用什么面粉7.7%。结论经后路松解楔形截骨矫治先天性胸腰段半椎体并重度僵硬性脊柱侧后凸畸形安全有效，选择TV 作为LIV 可以减少融合节段。
[关键词]先天性胸腰段半椎体；僵硬性脊柱侧后凸畸形；经后路松解楔形截骨术；融合节段选择
[中图分类号]R683.2[文献标识码]A [文章编号]1673-7210（2012）10（c ）-0056-03
The treatment of orthodontics of posterior mobilization cuneiform osteotomy in congenital half thoracolumbar vertebral body combined with vere rigid spinal kyphoscoliosis deformity
DAI Chonghua MA Bin苹果怎么卸载软件
Department of Orthopedics,the People ′s Hospital of Luliang County,Yunnan Province,Luliang 655600,China
[Abstract]Objective To investigate the safety and clinical preliminary effect of the orthodontics of congenital half thoracolumbar vertebral body combined with vere rigid spinal kyphoscoliosis deformity treated by posterior mobilization cuneiform osteotomy,and to discuss the gment choice of fusion and instrumentation.Methods The clinical data of 10cas with the orthodontics of congenital half thoracolumbar vertebral body combined with vere rigid spinal kyphoscoliosis deformity in our hospital from July 2006to October 2011were collected.All cas were treated by posterior mobilization cuneiform osteotomy with the touched vertebrae (TV)for the fusion and instrumentation lower end vertebrae.Results All the 10patients were completed the operation successfully,and 3.0intervertebral spaces were relead for average.Operation time was from 4.5to
9.4hours with 6.3hours for average;the intraoperative bleeding was between 680to 10000mL,for 985mL on average.The lateral protruding Cobb angles were between 6°to 32°,18.7°on average,the average correct rate was 27.2%;while kyphotic Cobb angles were from 8°to 22°,8.3°for average,average correction rate was 88.6%.The distance from C 7plumb line to the midline of sacrum was 0.1~2.3cm,which was 0.6cm on average.The average correction rate of coronal balance was 78.1%.All had been followed up for 14~35months,The lateral protruding Cobb angle was 29.7°on average at the last follow-up and the loss rate was 7.3%.The kyphotic Cobb angle was between 22°to 38°with 29.9°on average at the last follow-up,the loss rate was 7.7%.Conclusion It is safe and effective for the orthodontics of congenital half thoracolumbar vertebral body combined with vere rigid spinal kyphoscoliosis deformity treated by posterior mobilization cuneiform osteotomy.It can reduce fusion gments by choosing TV as lowest instrumented vertebrae.檐字组词
[Key words]Congenital half thoracolumbar vertebral body;Rigid spinal kyphoscoliosis deformity;Posterior mobilization cuneiform osteotomy;Fusion gments choice所向披靡是什么意思
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