海 涌.1型神经纤维瘤病伴脊柱侧凸肋骨头椎管内脱位的治疗策略[J].中国脊柱脊髓杂志,2017,27(6):488-489. |
1型神经纤维瘤病伴脊柱侧凸肋骨头椎管内脱位的治疗策略 |
中文关键词: 早发性脊柱侧凸 1型神经纤维瘤病 生长棒 |
中文摘要: |
【摘要】 目的:观察生长棒治疗1型神经纤维瘤病早发性脊柱侧凸的有效性。方法:回顾性分析13例生长棒治疗的1型神经纤维瘤病早发性脊柱侧凸患者的临床资料,其中男8例,女5例;年龄5~10岁(7.5±2.1岁)。随访时间2~10年(5.1±2.8年)。生长棒置入术后每6个月撑开1次。影像学测量指标包括侧凸Cobb角、后凸角、躯干高度(T1~S1),并统计手术并发症。结果:术前侧凸Cobb角69.0°±21.2°(43°~90°),末次随访25.3°±15.0°(12°~45°),矫正率63.3%。躯干高度术前323.0±29.1mm(288~355mm),末次随访400.5±25.7mm(361~430mm),躯干高度增加77.1±18.3mm,每年继续生长11.7±3.3mm。9例患者出现并发症,并发症发生率69.2%。共发生并发症16例次,包括内置物失败9例次(56.3%),交界区后凸5例次(31.3%),内置物外露1例次(6.2%),深部感染1例次(6.2%)。9例后凸角<50°患者中6例(66.7%)出现并发症,4例后凸角≥50°患者中3例(75%)出现并发症,两组并发症发生率差异无统计学意义(χ2=0.123,P=0.726)。结论:生长棒治疗1型神经纤维瘤病早发性脊柱侧凸可有效改善脊柱畸形,并且保持躯干的继续生长;伴有严重后凸并未增加术后并发症的发生率。 |
The treatment strategy for rib head protrusion into the spinal canal in type 1 neurofibromatosis scoliosis |
英文关键词:Early onset scoliosis Type 1 neurofibromatosis Growing rod |
英文摘要: |
【Abstract】 Objectives: To investigate the surgical outcome and complications of growing rods in the treatment of early onset scoliosis(EOS) with type 1 neurofibromatosis. Methods: Thirteen cases of EOS with type 1 neurofibromatosis treated with growing rods were studied retrospectively. There were 8 boys and 5 girls, aged from 5 to 10 years old(average, 7.5±2.1 ys). The average follow-up was 5.1±2.8 years(2-10 years). Exptending procedure was carried out every 6 months after first time internal fixation. The Cobb angle, kyphosis angle and trunk height were measured, and the complications were also evaluated. Results: The mean Cobb angle was corrected from 69.0°±21.2°(43°-90°) preoperatively to 25.3°±15.0°(12°-45°) at the final follow-up, the correction rate was 63.3%. The trunk height was corrected from 323.0±29.1mm(288-355mm) to 400.5±25.7mm(361-430mm), and spine grew an average of 11.7±3.3mm per year. There were 16 complications in 9 cases(69.2%), with implant failures in 9 cases(56.3%), junctional kyphosis in 5 cases(31.3%), and wound dehiscence and deep wound infection in 1 case(6.2%). Among 9 cases with kyphosis angle less than 50°, complication was found in 6 cases(66.7%); among 4 cases with kyphosis angle more than 50°, complication was found in 3 cases(75%). There was no significant difference of complication rate between kyphosis more than 50° group and that less than 50°group( χ2=0.123, P=0.726). Conclusions: The use of growing rods in patients with EOS associated with type 1 neurofibromatosis provides curve correction and allows the growth of spine. Kyphosis more than 50° does not increase complications. |
投稿时间:2017-05-18 修订日期:2017-05-29 |
DOI: |
基金项目:国家自然科学基金项目(编号:81572177) |
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