2014中国脊柱侧凸年会学术专题5：重度

2014中国脊柱侧凸年会学术专题5：重度

重度僵硬性脊柱侧后凸：术前头盆牵引的价值

SevereRigidKyphoscoliosis:theValueofHalo-VastorHalo-Gravitytraction

专题组织人：郑召民教授史亚民教授

重度僵硬性脊柱侧凸是指站立位冠状面Coob角60°～°,Bending像相柔韧性30%。即便采取分期医治或全脊椎截骨技术,改正率也很难超过60%[1]。

年Kane等［2］首次报导了运用Halo股骨髁上牵引医治脊柱侧凸患者后，Halo胫骨牵引、Halo骨盆牵引、Halo重力牵引等被应用于脊柱畸形的医治［］。研究表明运用牵引技术医治重度僵硬性脊柱侧凸可以改良此类脊柱畸形，且安全有效[]。术前牵引可以减少直接行矫形手术所引发的神经损伤［10］。

但是关于牵引是不是能改良脊柱畸形终究的矫形率存在争议，一部分学者认为［］不管术前是不是行牵引医治，侧弯畸形术后矫形率的比较无统计学意义。但Koptan等学者［］的相干研究证明严重僵硬特发性脊柱侧弯患者，牵引明显提高了术后的矫形率，并改良患者的肺功能［］。虽然牵引技术可有效医治重度僵硬性脊柱侧凸，下降神经并发症，减少不必要的脊椎截骨，改良肺功能，但是牵引可能带来的并发症是不能被忽视的。如感染、关节僵硬、第Ⅵ对脑神经损伤等，严重的可至截瘫［20］。

既然头盆环牵引存在诸多并发症，那末，您认为：目前运用术前头盆牵引医治重度僵硬性脊柱侧后凸在改良脊柱柔韧性、肺功能，提高矫形率；减少截骨范围及术中神经损伤、预防术后肺部并发症等方面存在运用价值吗？运用中有哪些注意事项吗？

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中国脊柱侧凸年会将于年8月日在北京举行，会议优秀学术壁报和青年医师脊柱畸形病例征集的投稿截止日期是年7月20日。

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