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Scoliosis Research Society
SRS: Scoliosis Research Society

Scoliosis Research Society

竭诚为患者的脊柱畸形的最佳治疗

 

脊柱后凸畸形

创伤性后凸畸形

病因
创伤后后凸畸形最常见于胸腰段和腰段。这种类型的后凸畸形最常见于合并严重神经功能障碍的患者,比如四肢瘫或截瘫患者。
(图1A所示))
40 yo M, CP, spastic quadriplegia, neuromuscular scoliosis Post traumatic kyphosis can occur due to the failure of the initial management of the injury or unrecognized injury. It may also result from inadequate surgical treatment as shown in the figures to the right. Post traumatic kyphosis can occur due to the failure of the initial management of the injury or unrecognized injury. It may also result from inadequate surgical treatment as shown in the figures to the right. Post traumatic kyphosis can occur due to the failure of the initial management of the injury or unrecognized injury. It may also result from inadequate surgical treatment as shown in the figures to the right.
图 1A-D所示:创伤性后凸畸形常由初期治疗失败及延误诊断造成,也可由如右图所示的手术治疗不当引起。

症状

后凸畸形可造成慢性致残性疼痛。疼痛来源主要包括

  • 椎旁肌肉疲劳
  • 慢性炎症及进行性退变
  • 前脊髓和神经的压迫或刺激

体格检查
当前柱及所有后方韧带断裂时会出现进行性的后凸畸形。截瘫患者也可能由于过度后凸造成坐起和体位改变困难。
治疗选择

后凸畸形的治疗目的主要是矫正畸形,稳定脊柱,减少疼痛,促进神经功能恢复。

柔软的畸形可通过后路固定融合进行矫正,僵硬固定的畸形常常需要更复杂的手术治疗。

References

  1. Atici T, A. U., Akesen B, Serifoglu R. (2004). "Results of surgical treatment for kyphotic deformity of the spine secondary to trauma or Scheuermann's disease." Acta Orthop Belg 70(4): 344-8.
  2. Been HD, P. R., Ubags LH. (2004). "Clinical outcome and radiographic results after surgical treatment of post-traumatic thoracolumbar kyphosis following simple type A fractures." Eur Spine J 13(2): 101-7.
  3. Jodoin A, G. P., Dupuis PR, Maurais G. (1989). "Surgical treatment of post-traumatic kyphosis: a report of 16 cases." Can J Surg. 32(1): 36-42.
  4. Klockner C, H. A., Weber U. (2001). "Post-traumatic kyphosis of the truncal vertebrae." Orthopade. 30(12): 947-54.
  5. Kostuik JP, M. H. (1989). "Anterior stabilization, instrumentation, and decompression for post-traumatic kyphosis." Spine. 14(4): 379-86.
  6. Lazennec JY, N. N., Rousseau MA, Boyer P, Pascal-Mousselard H, Saillant G. (2006). "Wedge osteotomy for treating post-traumatic kyphosis at thoracolumbar and lumbar levels." J Spinal Disord Tech. 19((7):): 487-94.
  7. Vaccaro AR, S. J. (2001). "Post-traumatic spinal deformity." 26 24(S111-8).
  8. Wawro W, B. N., Aebi M. (1992). "Technique of surgical correction of post-traumatic kyphosis." Unfallchirurg 95(1): 41-6.
  9. Wenger M, B. M., Markwalder TM. (2005). "Post-traumatic cervical kyphosis with surgical correction complicated by temporary anterior spinal artery syndrome." J Clin Neurosci 12(2): 193-6.
  10. Wu SS, H. S., Lin LC, Pai WM, Chen PQ, Au MK. (1996). "Management of rigid post-traumatic kyphosis." Spine. 21(19): 2260-7
  11. Zhi., Z. W. K. Z. (2005). "Surgical correction of post-traumatic kyphosis of thoracolumbar spine." 43(4): 201-4.