1、脊柱(jzh)(jzh)畸形截骨术 成人严重的僵硬的脊柱畸形,包括冠状位和失状位的畸形。通过截骨最终取得失状位和冠状位的平衡,缓解疼痛,坚固的融合(rngh)及预防进一步畸形。第一页,共二十二页。第二页,共二十二页。第三页,共二十二页。失状位失衡(sh hn)(sh hn)1、节段性tape1(segmental):SVA5cm without knee flexion or hip hyperextension Ideal sagittal alignment is described as SVA50 mm,PT 12 cm),sharp,angular kyphosis etl;第十一页
2、,共二十二页。A wide laminectomy is performedOsteotomy line horizontal to the sacrumPlacing the temporary rodclosed over the rods while the hips and knees are hyperextended第十二页,共二十二页。Interbody fusion can be done as either a TLIF or an ALIF procedure第十三页,共二十二页。Bone-disc-bone osteotomy(BDBO)correction rates
3、35 to 60The main indications are deformities with the disc space as the apex or center of rotational axis(CORA)and severe sagittal plane deformities第十四页,共二十二页。Type 1 bone-disc-bone osteotomy(BDBO).第十五页,共二十二页。Type 2 BDBO.第十六页,共二十二页。Type 3 BDBO.第十七页,共二十二页。pedicle screws at least two levels below and t
4、hree levels above A titanium mesh cage can be placed anteriorly if desired.第十八页,共二十二页。Vertebral column resection(VCR)in 1922 by MacLennanindicated for rigid multiplanar deformities,sharp angulated deformities,emivertebra resections,resectable spinal tumours,posttraumatic deformities,and spondyloptosis.第十九页,共二十二页。第二十页,共二十二页。第二十一页,共二十二页。内容(nirng)总结脊柱畸形截骨术。失状位失衡(sh hn)截骨方式Posterior-only。1、Smith-Petersen osteotomy(SPO)。3、bone-disc-bone osteotomy(BDBO)第二十二页,共二十二页。