脊柱截骨-医学课件.ppt

30 to 40 correction through all three columns, while avoiding stretch vessels and viscera anterior to the spine; If performed in an asymmetric fashion, provide significant coronal correction as well; * type 2 sagittal deformity (SVA12 cm), sharp, angular kyphosis etl； * A wide laminectomy is performed Osteotomy line horizontal to the sacrum Placing the temporary rod closed over the rods while the hips and knees are hyperextended * Interbody fusion can be done as either a TLIF or an ALIF procedure * Bone-disc-bone osteotomy (BDBO) correction rates 35° to 60° The main indications are deformities with the disc space as the apex or center of rotational axis (CORA) and severe sagittal plane deformities * Type 1 bone-disc-bone osteotomy (BDBO). * happy happy happy happy happy happy happy happy happy happy happy happy happy happy happy happy happy happy happy happy happy 脊柱畸形截骨术 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，坚固的融合及预防进一步畸形。   *  *  * 失状位失衡 1、节段性tape1（segmental）:SVA5cm 2、整体性tape2（global）:SVA 5cm without knee flexion or hip hyperextension Ideal sagittal alignment is described as SVA50 mm, PT 25 ゜, PI–LL = 10 ゜   * 失状位失衡截骨方式Posterior-only  1、Smith-Petersen osteotomy (SPO) 2、pedicle subtraction osteotomy (PSO) 3、bone-disc-bone osteotomy (BDBO) 4、vertebral column resection (VCR) * Ponte osteotomy, Smith-Petersen osteotomy (SPO) removal of posterior ligaments and facets * wide facetectomy to prevent nerve root impingement osteotomy site can be done asymmetrically to correct coronal imbalance as well as sagittal imbalance * 9.3–10.7 per level. substantial correction, it may be necessary to graft the disc space anteriorly Type 1 a long, rounded,smooth kyphosis SVA in the range of 6–8 cm positive. easier and safer than other osteotomies; * Pedicle subtraction osteotomy(PSO) Thomasen in 1985. Heining et al eggshell osteotomy. * happy happy happy happy happy happy happy happy happy happy ha