脊柱后凸畸形手术截骨临床研究进展
Clinical Research Progress of Spinal Osteotomy for Correction of Spine Kyphosis

作者: 欧阳云飞 :解放军总医院2011级博士队,北京; 王 岩 , 张永刚 , 张雪松 , 黄 鹏 , 郑国权 :解放军总医院骨科,北京;

关键词: 脊柱畸形截骨术后凸畸形Spinal Deformity Osteotomy Kyphosis

摘要:
严重的脊柱后凸畸形往往需要手术矫正,脊柱截骨技术的应用必不可少。传统截骨术可分为:SPO、PSO、以及VCR等截骨术式,不同的畸形采用不同的截骨术,严重的畸形可能会采用两种以上截骨术式。重度脊柱畸形的截骨矫正手术难度大,神经损伤的并发症发生率较高,恰当的截骨术式和医生的手术经验是手术成功的关键所在。解放军总医院骨科王岩教授近年来开创的新术式(VCD)截骨在矫正重度脊柱畸形方面取得了一些成功经验。本文从截骨术的历史到截骨术的分类,以及当前截骨术的新进展全面介绍截骨术矫正脊柱后凸畸形的发展和临床应用。

Abstract: Severe spinal deformity often requires surgical correction. The application of the spinal osteotomy is indispensable. Traditional osteotomies can be divided into: Smith-Petersen Osteotomy (SPO), Pedicle Subtraction Osteotomy (PSO) and Vertebral Column Resection (VCR). Different deformities use different osteotomies. Severe deformity may use two or more osteotomies. The spine corrective surgery of severe deformity is difficult. Occurrence rate of complications of the nerve damage is high. Proper osteotomy and the doctor’s surgical experience are the keys to successful operation. Professor Wang in Department of Orthopedics, Chinese PLA General Hospital has created a new osteotomy named Vertebral Column Decancellation (VCD) in recent years which obtains some successful experience in the correction of the severe spinal deformity. This article comprehensively introduced the development and the clinical application of osteotomy in correction of spinal deformity from the history, the classification and the new progress of the osteotomy.

文章引用: 欧阳云飞 , 王 岩 , 张永刚 , 张雪松 , 黄 鹏 , 郑国权 (2015) 脊柱后凸畸形手术截骨临床研究进展。 临床医学进展, 5, 212-218. doi: 10.12677/ACM.2015.54034

参考文献

[1] 王岩. 对脊柱畸形截骨矫治及退行性脊柱畸形治疗的认识[J]. 中国脊柱脊髓杂志, 2011, 21(9): 706-707.

[2] Lennan, M. (1922) Scoliosis. British Medical Journal, 2, 865-866.

[3] Smith-Petersen, M.N., Larson, C.B. and Aufrance, O.E. (1945) Osteotomy of the Spine for Correction of Flexion Deformity in Rheumatoid Arthritis. The Journal of Bone and Joint Surgery British Volume, 27, 1-11.

[4] Ponte, A., Vero, B. and Siccardi, G.L. (1984) Surgical Treatment of Scheuermann’s Hyperkyphosis. In: Winter, RB., Ed., Progress in Spinal Pathology: Kyphosis, Aulo Gaggi, Bologna, 75-80.

[5] Michele, A. and Krueger, F.J. (1949) A Surgical Approach to the Vertebral Body. The Journal of Bone and Joint Surgery. American Volume, 31, 873-878.

[6] Thomasen, E. (1985) Vertebral Osteotomy for Correction of Kyphosis in Ankylosing Spondylitis. Clinical Orthopaedics and Related Research, 194, 142-152.
http://dx.doi.org/10.1097/00003086-198504000-00019

[7] Heining, C.F. and Luque, E.R. (1984) Segmental Spine Instrumentation. Slack Incorporated Thorofare, New Jersey, 5, 221-234.

[8] Byrd 3rd, J.A., Scoles, P.V., Bradford, D.S., et al. (1987) Adult Idiopathic Scoliosis Treated by Anterior and Posterior Spinal Fusion. The Journal of Bone and Joint Surgery American Volume, 69, 843-850.

[9] Bradford, D.S. and Tribus, C.B. (1997) Vertebral Column Resection for the Treatment of Rigid Coronal Decompensation. Spine, 22, 1590-1599.
http://dx.doi.org/10.1097/00007632-199707150-00013

[10] Suk, S.I., Kim, J.H., Kim, W.J., et al. (2002) Posterior Vertebral Column Resection for Severe Spinal Deformities. Spine, 27, 2374-2382.
http://dx.doi.org/10.1097/00007632-200211010-00012

[11] Lenke, L.G., O’Leary, P.T., Bridwell, K.H., Sides, B.A., Koester, L.A. and Blanke, K.M. (2009) Posterior Vertebral Column Resection for Severe Pediatric Deformity: Minimum Two-Year Follow-Up of Thirty-Five Consecutive Patients. Spine, 34, 2213-2221.
http://dx.doi.org/10.1097/BRS.0b013e3181b53cba

[12] Suk, S.I., Chung, E.R., Kim, J.H., Kim, S.S., Lee, J.S. and Choi, W.K. (2005) Posterior Vertebral Column Resection for Severe Rigid Scoliosis. Spine, 30, 1682-1687.
http://dx.doi.org/10.1097/01.brs.0000170590.21071.c1

[13] Lenke, L.G., Sides, B.A., Koester, L.A., Hensley, M. and Blanke, K.M. (2010) Vertebral Column Resection for the Treatment of Severe Spinal Deformity. Clinical Ortho-paedics and Related Research, 468, 687-699.
http://dx.doi.org/10.1007/s11999-009-1037-x

[14] 史亚民, 金大地, 王岩, 王以朋, 吕国华, 海涌, 邱勇. 全脊椎截骨或切除术矫治脊柱侧后凸畸形的相关问题探讨[J]. 中国脊柱脊髓杂志, 2007, 17(4): 250-251.

[15] Smith, J.S., Wang, V.Y. and Ames, C.P. (2008) Vertebral Column Resection for Rigid Spinal Deformity. Neurosurgery, 63, 177-182.
http://dx.doi.org/10.1227/01.NEU.0000320429.32113.85

[16] Lenke, L.G., Newton, P.O., Sucato, D.J., Shufflebarger, H.L., Emans, J.B., Sponseller, P.D., et al. (2013) Complications Following 147 Consecutive Vertebral Column Resections for Severe Pediatric Spinal Deformity: A Multicenter Analysis. Spine, 38, 119-132.

[17] Kim, S.S., Cho, B.C., Kim, J.H., Lim, D.J., Park, J.Y., Lee, B.J. and Suk, S.I. (2012) Complications of Posterior Vertebral Resection for Spinal Deformity. Asian Spine Journal, 6, 257-265.
http://dx.doi.org/10.4184/asj.2012.6.4.257

[18] 季明亮, 邱勇. 后路全脊椎切除截骨矫形术神经并发症的危险因素及预防进展[J]. 中国脊柱脊髓杂志, 2011, 21(4): 334-337.

[19] Sponseller, P.D., Jain, A., Lenke, L.G., Shah, S.A., Sucato, D.J., Emans, J.B. and Newton, P.O. (2012) Vertebral Column Resection in Children with Neuromuscular Spine Deformity. Spine, 37, E655-E661.
http://dx.doi.org/10.1097/brs.0b013e318244460d

[20] 王岩, 张永刚, 张雪松, 肖嵩华, 王征, 毛克亚, 刘郑生, 刘保卫, 陆宁, 朱守荣, 张西峰, 黄鹏. 单纯后路多个全脊椎切除矫治严重脊柱侧、后凸畸形[J]. 脊柱外科杂志, 2007, 5(2): 65-68.

[21] Wang, Y., Zhang, Y.G., Zhang, X.S., Huang, P., Xiao, S.H., Wang, Z., et al. (2008) A Single Posterior Approach for Multilevel Modified Vertebral Column Resection in Adults with Severe Rigid Congenital Ky-phoscoliosis: A Retrospective Study of 13 Cases. European Spine Journal, 17, 361-372.
http://dx.doi.org/10.1007/s00586-007-0566-9

[22] Wang, Y., Zhang, Y.G., Zhang, X.S., Wang, Z., Mao, K.Y., Chen, C., et al. (2009) Posterior-Only Multilevel Modified Vertebral Column Resection for Extremely Severe Pott’s Kyphotic Deformity. European Spine Journal, 18, 1436-1441.
http://dx.doi.org/10.1007/s00586-009-1067-9

[23] 王岩, 张永刚, 郑国权, 肖嵩华, 张雪松, 王征. 脊柱去松质骨截骨治疗僵硬性脊柱侧凸的有效性及安全性分析[J]. 中华外科杂志, 2010, 48(22): 1701-1704.

[24] Wang, Y. and Lenke, L.G. (2011) Vertebral Column Decancellation for the Management of Sharp Angular Spinal Deformity. European Spine Journal, 20, 1703-1710.
http://dx.doi.org/10.1007/s00586-011-1771-0

[25] Lenke, L.G. and Cho, W. (2010) Vertebral Osteotomies—Review of Current Concepts. US Musculoskeletal Review, 5, 46-49.

[26] Kim, K.T., Park, K.J. and Lee, J.H. (2009) Osteotomy of the Spine to Correct the Spinal Deformity. Asian Spine Journal, 3, 113-123.
http://dx.doi.org/10.4184/asj.2009.3.2.113

[27] Dorward, I.G. and Lenke, L.G. (2010) Osteotomies in the Posterior-Only Treatment of Complex Adult Spinal Deformity: A Comparative Review. Neurosurgical Focus, 28, E4.
http://dx.doi.org/10.3171/2009.12.FOCUS09259

[28] 刘祥胜, 朱晓东, 白玉树, 吴大江, 吴冰, 易红蕾, 李明, 王达义. Ponte截骨与SPO截骨联合后路全椎弓根螺钉系统矫正僵硬性青少年特发性胸椎侧凸的疗效比较[J]. 中国矫形外科杂志, 2012, 20(15): 1350-1355.

[29] Murrey, D.B., Brigham, C.D., Kiebzak, G.M., Finger, F. and Chewning, S.J. (2002) Transpedicular Decompression and Pedicle Subtraction Osteotomy (Eggshell Procedure): A Re-trospective Review of 59 Patients. Spine, 27, 2338- 2345.
http://dx.doi.org/10.1097/00007632-200211010-00006

[30] Heary, R.F. and Albert, T.J. (2007) Spinal Deformities: The Essentials. Thieme Medical Publishers, Stuttgart, 252-256.

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