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[目的]通过临床病例回顾性研究,对改良型经椎弓根截骨治疗伴后凸畸形的小儿胸腰段治愈型结核的疗效进行系统评估。[方法]回顾分析2008年1月~2012年7月间进行手术治疗的36例小儿胸腰段治愈型结核伴后凸畸形的患者,通过对比C7铅垂线与S1后上角距离,胸腰段Cobb角、VAS及ODI评分,评价患者畸形矫形效果及生活质量,评估改良型经椎弓根截骨治疗小儿胸腰段治愈型结核伴后凸畸形的疗效。[结果]本组36例患者均得到随访,随访时间18~56个月,平均41个月。所有患儿伤口均一期愈合。无神经功能损伤等严重并发症。C7铅垂线与S1后上角距离术前为(105.0±11.40)mm,术后纠正为(38.0±5.91)mm,胸腰段Cobb角由术前(60.60±3.70)°缩小为术后的(19.7±2.2)°。患者畸形得到较好的矫正,重建了矢状位平衡。VAS及ODI评分术前术后对比差异均有统计学意义(P<0.05),患者生活质量得到明显改善。[结论]采用改良型经椎弓根截骨术(MPSO)治疗小儿胸腰段治愈型结核伴后凸畸形矫形效果明显,手术时间短,手术风险相对较小,后凸矫果好,术后并发症少,融合率高,患儿满意度高。
[Objective] To systematically evaluate the curative effect of modified pedicle osteotomy for pediatric thoracolumbar cured tuberculosis with kyphosis by retrospective clinical study. [Methods] A retrospective analysis of 36 cases of pediatric thoracolumbar cured tuberculosis with kyphosis who underwent surgical treatment between January 2008 and July 2012 was performed. By comparing the C7 plumb line and the upper posterior angle of S1, Section Cobb angle, VAS and ODI score to evaluate the orthodontic effect and quality of life of patients, and to evaluate the curative effect of modified trans-pedicle osteotomy for the treatment of children with thoracolumbar cured tuberculosis with kyphosis. [Results] Thirty-six patients in this group were followed up for 18-56 months with an average of 41 months. All children with wound healing. No serious neurological injury and other complications. The distance between C7 plumb line and upper posterior angle of S1 was (105.0 ± 11.40) mm preoperatively and (38.0 ± 5.91) mm postoperatively, while the thoracolumbar Cobb angle decreased from 60.60 ± 3.70 ° postoperatively to (19.7 ± 2.2) °. Patients deformity has been better corrected, the reconstruction of the sagittal balance. VAS and ODI scores before and after surgery were significantly different (P <0.05), patients with quality of life has been significantly improved. [Conclusion] The modified pedicle osteotomy (MPSO) treatment of pediatric thoracolumbar cured tuberculosis with kyphosis deformity effect is obvious, the operation time is short, the operation risk is relatively small, kyphosis good results, postoperative Less complications, high fusion rate, high satisfaction in children.