霍喜卫,李 锋,熊 伟,张 帆,姚广清,牛朋彦,卢伟伟.青少年特发性脊柱侧凸再手术原因分析与策略[J].中国脊柱脊髓杂志,2010,20(12):988-992.
青少年特发性脊柱侧凸再手术原因分析与策略
中文关键词:  青少年特发性脊柱侧凸  再手术  并发症
中文摘要:
  【摘要】 目的:分析青少年特发性脊柱侧凸初次术后再手术常见原因,并探讨治疗策略及预防措施。方法:2003年1月~2008年12月我院收治的特发性脊柱侧凸再手术病例10例,收集其初次矫形术前、术后随访及再手术术后的相关影像资料、初次手术和再手术策略等资料进行回顾性分析。结果:10例中5例因侧凸进展而采用延长融合范围治疗;1例因近端交界后凸加剧而需向近端延长融合范围;3例感染患者接受了清创及抗生素治疗,其中2例保留了内固定,1例为控制感染而取出内固定;1例假关节形成患者采用更换断裂内固定及局部植骨治疗。所有患者经随访12~33个月(平均21.5个月),脊柱平衡保持良好,无侧凸进展、失代偿、内固定失败等并发症。结论:特发性脊柱侧凸术后常见再手术原因包括侧凸进展、感染、假关节形成、近端异常交界后凸等,选择合适的再手术策略可以取得满意的疗效。
Cause analysis of and surgical strategy for revision surgery for adolescent idiopathic scoliosis
英文关键词:Adolescent idiopathic scoliosis  Reoperation  Complication
英文摘要:
  【Abstract】 Objective:To investigate the common causes and surgical strategy for revision surgery for adolescent idiopathic scoliosis.Method:10 patients underwent revision surgery due to failed primary spinal fusion surgery in our hospital from January 2003 to December 2008.Their detailed image data collected pre- and postoperatively,during the follow-up and the revision surgery,as well as the surgical strategies for both primary and revision surgery were collected and reviewed retrospectively.Result:Of 10 revision surgeries,fusion segments were extended due to progressive scoliosis in 5 surgeris;1 patient underwent proximal fusion extension due to proximal junctional kyphosis;3 patients had debridement and antibiotic therapy due to infection and instrument were maintained in 2 cases;1 patient underwent implant replacement and autograft due to pseudarthrosis and instrument failure.All 10 patients were followed up for 12~33 months(average,21.5 months).At final follow-up,no malalignment,no scoliosis progression and disimbursement and instrument failure were noted.Conclusion:The most common causes for revision surgery for adolescent idiopathic scoliosis are curve progression,infection,pseudarthrosis and abnormal proximal junctional kyphosis.Proper revision strategy can ensure satisfactory results.
投稿时间:2010-07-08  修订日期:2010-09-19
DOI:10.3969/j.issn.1004-406X.2010.[issue].988.4
基金项目:
作者单位
霍喜卫 华中科技大学同济医学院附属同济医院骨科 430030 武汉市 
李 锋  
熊 伟  
张 帆  
姚广清  
牛朋彦  
卢伟伟  
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