Perioperative Halo-Gravity Traction in the Treatment of Scoliosis with Intraspinal Anomalies
Perioperative Halo-Gravity Traction in the Treatment of Scoliosis with Intraspinal Anomalies
复制标题
围手术期光环重力牵引治疗伴有椎管内异常的脊柱侧弯
DOI：
10.1016/j.wneu.2020.04.242
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发表时间：
2020
影响因子：
2
通讯作者：
Hao Dingjun
中科院分区：
文献类型：
--
作者：
Sun Kai;Hu Huimin;Gao Lin;Huang Dageng;Yang Tong;Hao Dingjun
目的探讨术前光环重力牵引加一期后路手术治疗脊柱侧凸伴髓内异常的疗效和安全性。方法对11例脊柱侧弯伴髓内异常患者进行评价。所有患者均接受术前光环重力牵引和一期后路手术治疗。平均年龄为 11.4 岁（范围：7-21 岁）。所有患者均随访至少 2 年（平均 3.5 年；范围 2-5 年）。回顾其影像学表现及并发症。结果手术时间7.9小时，术中出血量1890mL。光环重力牵引和手术治疗后，脊柱侧弯和后凸Cobb角均明显改善（P<0.05）。释放系住的绳索，切除椎管内肿块（神经纤维瘤和脂肪瘤）。脊髓空洞症和脊髓分裂畸形没有得到治疗。手术后，没有患者的神经系统状态出现恶化。术后未发生感染、脑脊液漏、内固定失败、椎弓根螺钉或椎棒折断等严重并发症。随访期间未出现神经功能恶化、迟发感染、假关节等症状。结论术前光环重力牵引和一期后路手术为脊柱侧凸及髓内异常患者提供了有效、安全的治疗选择，并发症少。
ObjectiveTo investigate the efficacy and safety of preoperative halo-gravity traction and 1-stage posterior surgery for the treatment of scoliosis with intramedullary anomalies.MethodsA total of 11 patients with scoliosis with intramedullary anomalies were evaluated. All patients were treated with preoperative halo-gravity traction and 1-stage posterior surgery. The average age was 11.4 years (range, 7–21 years). All patients were followed-up for at least 2 years (mean, 3.5 years; range, 2–5 years). Their radiologic presentations and complications were reviewed.ResultsThe operating time was 7.9 hours, and the intraoperative bleeding amount was 1890 mL. Both the Cobb angle of scoliosis and kyphosis were significantly improved after halo-gravity traction and the operation (P< 0.05). Tethered cords were released, and intraspinal masses (neurofibromatosis and lipoma) were excised. Syringomyelia and split spinal cord malformations were left untreated. None of the patients experienced deterioration in their neurologic status after surgery. No severe complications, such as infection, cerebrospinal fluid leakage, failed internal fixation, or fractured pedicle screws or rods occurred after the operation. There was no deterioration of neurologic function, delayed infection, or pseudoarthrosis during the follow-up visits.ConclusionsPreoperative halo-gravity traction and 1-stage posterior surgery provided patients who had scoliosis and intramedullary anomalies an effective and safe treatment option with few complications.