Objective:To evaluate the clinical curative effect of the modified Halo pelvic frame and surgery for the treatment of severe scoliosis with rigidity. Methods: From January 2004 to May 2010,50 patients with severe scoliosis patients with rigidity were treated in our hospital. Twenty-three patients were male and 27 patients were female,with a mean age of 10.8 years old,ranging from 4 to 16 years. Twenty-four patients were congenital scoliosis and 26 patiens were idiopathic scoliosis. The mean body height were (152.1 ±11.1) cm and the average Cobb angle of scoliosis and kyphosis were (91.8±14.5)° and (69.5±14.0)° respectively. All the patients were treated with three-stages modified Halo pelvic traction,the second stage anterior release and the third stage posterior correction. The amount of correction was determined by measuring the change of body height,the Cobb angles and correction rate of scoliosis as well as kyphosis before and after the operation. Results;The mean body height were correct to (158.5±10.5) cm. The average Cobb angle of scoliosis were correct to (30.8±7.9)°. The average Cobb angle of kyphosis were correct to(31.6±10.1)°. After the first stage, the average Cobb angle of scoliosis and kyphosis were changed with the mean of(30.4±6.6)% correction and (22.3±5.2)% respectively;after the second stage,the average Cobb angle of scoliosis and kyphosis were changed with the mean (26.7±5.1)% correction and (21.2±6.0)% respectively;the third stage,above data were(33.7±7.2)% and(27.1±5.3)%. Correction rate of scoliosis and kyphosis were (66.5±7.2)% and (55.1± 6.4)% respectively by the modified Halo pelvic frame traction and surgery. Body height,the Cobb angles and correction rate of scoliosis and kyphosis on radiographs were different in all stages (P<0.05). Conclusion: Operative complications of severe scoliosis with rigidity can be reduced and better deformity correction and trunk balance achieved by the modified Halo pelvic frame traction and surgery.%目的:探讨改良Halo-骨盆架分期牵引联合手术治疗重度僵硬性脊柱侧凸的临床疗效.方法:自2004年1月至2010年5月治疗50例重度僵硬性脊柱侧凸患者,男23例,女27例;年龄4～16岁,平均10.8岁;先天性脊柱侧凸24例(分节不良11例,形成障碍7例,混合型6例),特发性脊柱侧凸26例.采用改良Halo-骨盆架分期牵引联合手术治疗:Ⅰ期术前牵引,Ⅱ期松解牵引,Ⅲ期牵引矫形内固定.对治疗前后患者身高、侧凸Cobb角、后凸Cobb角及矫正率进行观察.结果:患者身高由治疗前平均(152.1±11.1)cm矫正至(158.5±10.5)cm,侧凸Cobb角由平均(91.8±14.5)°矫正至(30.8±7.9)°,后西Cobb角由平均(69.5±14.0)°娇正至(31.6±10.1)°.Ⅰ期术前牵引后侧凸、后凸Cobb角平均娇正率分别为(30.4±6.6)%、(22.3±5.2)%;Ⅱ期松解牵引后侧凸、后凸Cobb角平均娇正率分别为(26.7±5.1)%、(21.2±6.0)%;Ⅲ期牵引矫形内固定后侧凸、后凸Cobb角平均娇正率分别为(33.7±7.2)%、(27.1±5.3)%(娇正率参照的基准Cobb角是上一期治疗的Cobb角);分期牵引联合手术治疗的侧凸、后凸Cobb角平均娇正率分别为(66.5±7.2)%、(55.1±6.4)%.各期治疗前后患者身高、侧凸Cobb角、后凸Cobb角及娇正率差异均有统计学意义(P<0.05).结论:采用改良Halo-骨盆架分期牵引联合手术治疗重度僵硬性脊柱侧凸,可获得良好的畸形娇正和躯干平衡,并能减少术中、术后并发症,具有临床可操作性.
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