微创式V型截骨分次矫正强直性脊柱后凸.doc

微创式V型截骨分次矫正强直性脊柱后凸

【摘要】[目的]用微创式V型截骨分次矫正强直性脊柱后凸的手术方法代替传统的手术方法,减轻了对病人的手术创伤,将复杂的大手术变为简单的微创手术,给病人减少了痛苦,节约了病人的经费开支。[方法]在局部浸润麻醉下,先用C型臂X线机选择截骨间隙,切口长6~8 cm,仅暴露1个椎板间隙,椎板V型截骨宽度8~10 mm,截骨完成后将手术床由反V型调成V型,截骨间隙将自动闭合复位,如不能自动闭合则轻轻按压帮助复位,一般复位均不成问题。将截骨时取下来的骨条作椎板后植骨。术毕应严格按照搬运规则将病人送回病房卧平床。术后2周内给予分次手法矫正和过伸位石膏背心固定。[结果]本组50例,除1例因过早自行拆除石膏背心造成畸形复发外,其余病例矫形效果满意,截骨部位骨性融合坚固。[结论]微创式截骨矫正术,损伤小、不用内固定减少病人的经济开支,V型截骨复位后互相嵌插稳定,用骨刀截骨间隙对合整齐,再加上椎板后植骨,过伸位石膏背心外固定,故均能在6个月后植骨融合坚固。
【关键词】微创; V型截骨; 分次矫正; 强直性脊柱后凸

Minimally invasive V-shaped osteotomy for the correction of ankylosing spondylitis kyphosis//TIAN Hui-zhong,MA Yuan, of Spinal Surgery,the 6th Affillated Hospital of Xinjiang Medical University,Wulumuji,Xinjiang 830002,China
Abstract:[Objeetive] To investigate the effect of minimally invasive V-shaped osteotomy instead of traditional operative technique for correction of ankylosing kyphosis.[Method]The C-arm X-ray was used under the local anaesthesia to select the space of osteotomy,the length of incision were 6~8 cm and only exposed one interlaminal space,the width of laminar V-shaped osteotomy were 8~10 operating table was changed from reverse V to type after finished osteotomy,the space of osteotomy would be automatica ly closed and replaced,if the space could not be automaticly closed,careful manipulation would be applied to close bone mass of osteotomy was used in posterior bone graft of ,stric and standardized regulation were performed to send the patient back to fractional manual correction and external fixation of hyperextended plaster vest were performed respectivly 2 weeks after operation.[Result]Fifty patients of this group acquired more satisfied results except 1 case appeared recurrent deformity due to early removing of the plaster vest.[Conclusion]Minimal damage,lower medical expenses(without internal fixation)and satisfied results demonstrated the minimally invasive V-shaped osteotomy is a very effective has