头盆环牵引全脊柱截骨内固定治疗重度脊柱弯曲

头盆环牵引全脊柱截骨内固定治疗重度脊柱弯曲【摘要】 ［目的］介绍头盆环牵引全脊柱截骨加内固定治疗重度脊柱弯曲的手术方法，并总结 185 例重度脊柱弯曲的治疗结果。［方法］对重度脊柱侧弯患者，先用头盆环牵引，使重弯变为轻弯，以便置入器械的安装，再在头盆环牵引下进行截骨矫正畸形和内固定手术，术后继续配戴头盆环制动，术后第 2 d 即可下床站立活动，给护理工作带来极大方便。［结果］作者自 1983～2025 年，采纳此法治疗重度脊柱侧弯 185 例，平均矫正率是%。脊柱截骨断端能达到坚固的骨性融合，矫正率丢失平均在 5°以内，术后晚期并发脱钩者4 例，均经再次手术固定解决，对矫正效果无影响。1 例术后 1 年并发感染，拆除置入器械后，伤口很快愈合，X 线所见植骨愈合良好。1 例并发神经根痛苦，而后逐渐减轻，所有病例未见脊髓损伤和神经系统并发症发生。［结论］头盆环牵引加全脊柱截骨是治疗重度脊柱侧弯的有效方法，对那些仅用单纯器械无法安装，置入困难的病例，经头盆环牵引后，内固定器械容易安装，再加上全脊柱截骨，能使弯曲的脊柱进一步伸直，减轻了内固定器械所承受的负荷力，避开了脱钩断棍的发生，为治疗重度脊柱侧弯的有效手段。【关键词】 重度脊柱侧弯 头盆环牵引 全脊柱截骨术 Halo pelvic distraction in combination with total spine osteotomy and internal fixation for treatment of severe scoliosis Abstract：［Objective］To report the records of 185 patients in whom severe scoliosis had been treated with preoperative halo pelvic distraction and following total spine osteotomy and internal fixation.［Method］Preoperative halo pelvic distraction was applied to all patients to reduce the severity of curvatures and make the following treatment total spine osteotomy and internal fixation were performed to rectify the remained deformity of the pelvic distraction was maintained during the operation and postoperatively to limit the mobilization of the one day after the operation,the patients were able to get out of bed,stand up and move around,making nursing care more convenient.［Result］Between 19...