后路全脊椎截骨术治疗合并脊髓空洞重度僵硬性脊柱侧后凸畸形的安全性及疗效分析

摘要

Objective To investigate the safety and efficacy of of posterior vertebral column resection (PVCR) for severe and rigid kyphoscoliosis assiociated with syringomyelia. Methods A total of 16 patients,diagnosed as severe and rigid kyphoscoliosis assiociated with syringomyelia, from Oct 2009 to Mar 2013 in our hospital, the patients had undergone PVCR. Patients who had combined with Chiar-I malformation, had underwent posterior fossa decompression before the kyphoscoliosis correction. The operation time ,intraoperative blood loss and complications were recorded. Results There were significant differences between pre-and post-operative coronal Cobb angle,thoracic kyphosis Cobb angle (P<0.05);there was no significant differences between post-operative and last follow-up coronal Cobb angle, thoracic kyphosis Cobb angle (P>0.05). Conclusion PVCR for severe and rigid kyphoscoliosis assiociated with syringomyelia is an ef-fective and safe method. However,additional large multicenter studies are necessary to further as-sess the safety and efficacy.%目的：探讨后路全脊椎截骨术（Posterior Vertebral Column Resection,PVCR）治疗合并脊髓空洞的重度僵硬性脊柱侧后凸的安全性及临床疗效。方法回顾分析2009-10-2013-03在我院接受PVCR手术治疗的合并脊髓空洞的重度僵硬性脊柱侧后凸畸形患者16例；其中同时伴发Chiari畸形I型患者在脊柱畸形截骨矫行前均先于神经外科进行后颅凹减压术；对于单纯合并脊髓空洞患者，直接进行脊柱截骨畸形矫治；记录手术时间、出血量及围手术期并发症情况。结果手术前、后冠状面及矢状面主弯Cobb角比较，差异具有统计学意义（P<0.05）；手术后与末次随访时冠状面及矢状面主弯Cobb角比较，差异无统计学意义（P＞0.05）。结论对于合并脊髓空洞的重度僵硬性脊柱侧后凸畸形，采用PVCR进行治疗，可获得安全、有效的临床结果。