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[目的]观察单纯行半椎体切除不使用脊柱内固定器械治疗小儿先天性脊柱侧弯的可行性及疗效。[方法]2000年4月～2012年8月在本院获得随访的经后路单纯半椎体切除的先天性脊柱侧弯患儿20例,3岁以下组14例,平均年龄10.9个月;3岁以上组6例,平均年龄6岁。半椎体位于胸段9例,胸腰段8例,腰段4例,骶段3例。术中均行后路经椎弓根单纯半椎体切除。术后随访3～7年,平均5.5年。[结果]手术时间平均173 min,手术出血平均116 ml,4例患儿未输血。3岁以下组Cobb角矫正率平均38.05%;3岁以上组Cobb角矫正率平均23.57%。术前Cobb角<40°者,术后矫正率平均41.78%;术前Cobb角≥40°者,术后矫正率平均25.25%。[结论]①对于年龄小于3岁的先天性脊柱侧弯患儿,后路半椎体切除而不使用内固定是一种可行的治疗方法,具有手术时间短、出血量少、矫形效果满意的优点;②对于Cobb角<40°的先天性脊柱侧弯患儿,该手术方式治疗效果优于Cobb角≥40°时的治疗效果。
[Objective] To observe the feasibility and curative effect of simple hemivertebra resection without congenital scoliosis in pediatric patients with congenital scoliosis. [Methods] From April 2000 to August 2012, 20 cases of congenital scoliosis and 14 cases under 3 years old with mean hemivertebra resection were treated in our hospital. The average age was 10.9 months. 3 years old and above group 6 cases, average age 6 years old. Half vertebra in the thoracic in 9 cases, thoracolumbar in 8 cases, lumbar in 4 cases, 3 cases of sacral. All patients underwent transseptal simple hemivertebra resection. The patients were followed up for 3 to 7 years, with an average of 5.5 years. [Results] The average operation time was 173 min, the average bleeding volume was 116 ml, and 4 cases had no blood transfusion. Cobb angle correction rate was 38.05% in the group under 3 years old and 23.57% in the group over 3 years old. Preoperative Cobb angle <40 °, the average rate of postoperative correction was 41.78%; preoperative Cobb angle ≥ 40 °, postoperative correction rate average 25.25%. [Conclusion] ① For children with congenital scoliosis less than 3 years old, posterior hemivertebra resection without internal fixation is a feasible treatment method with short operation time, less bleeding, and satisfactory orthopedic effect Advantages; ② For children with congenital scoliosis Cobb angle <40 °, the surgical treatment is better than the Cobb angle ≥ 40 ° when the treatment effect.