脊柱截骨專業(yè)知識宣講培訓(xùn)課件

脊柱截骨專業(yè)知識宣講

2脊柱截骨專業(yè)知識宣講

3脊柱截骨專業(yè)知識宣講失狀位失衡1、節(jié)段性tape1（segmental）:SVA<5cm2、整體性tape2（global）:SVA>5cmwithoutkneeflexionorhiphyperextension

IdealsagittalalignmentisdescribedasSVA<50mm,PT<25゜,PI–LL=10゜

4脊柱截骨專業(yè)知識宣講

失狀位失衡截骨方式Posterior-only

1、Smith-Petersenosteotomy(SPO)2、pediclesubtractionosteotomy(PSO)3、bone-disc-boneosteotomy(BDBO)4、vertebralcolumnresection(VCR)5脊柱截骨專業(yè)知識宣講Ponteosteotomy,Smith-Petersenosteotomy(SPO)removalofposteriorligamentsandfacets6脊柱截骨專業(yè)知識宣講9.3–10.7perlevel.substantialcorrection,itmaybenecessarytograftthediscspaceanteriorlyType1along,rounded,smoothkyphosisSVAintherangeof6–8cmpositive.easierandsaferthanotherosteotomies;8脊柱截骨專業(yè)知識宣講Pediclesubtractionosteotomy(PSO)Thomasenin1985.Heiningetaleggshellosteotomy.9脊柱截骨專業(yè)知識宣講30to40correctionthroughallthreecolumns,whileavoidingstretchvesselsandvisceraanteriortothespine;Ifperformedinanasymmetricfashion,providesignificantcoronalcorrectionaswell;10脊柱截骨專業(yè)知識宣講type2sagittaldeformity(SVA>12cm),sharp,angularkyphosisetl；11脊柱截骨專業(yè)知識宣講AwidelaminectomyisperformedOsteotomylinehorizontaltothesacrumPlacingthetemporaryrodclosedovertherodswhilethehipsandkneesarehyperextended12脊柱截骨專業(yè)知識宣講InterbodyfusioncanbedoneaseitheraTLIForanALIFprocedure13脊柱截骨專業(yè)知識宣講Bone-disc-boneosteotomy(BDBO)

correctionrates35°to60°Themainindicationsaredeformitieswiththediscspaceastheapexorcenterofrotationalaxis(CORA)andseveresagittalplanedeformities14脊柱截骨專業(yè)知識宣講Type1bone-disc-boneosteotomy(BDBO).15脊柱截骨專業(yè)知識宣講Type2BDBO.16脊柱截骨專業(yè)知識宣講Type3BDBO.17脊柱截骨專業(yè)知識宣講pediclescrewsatleasttwolevelsbelowandthreelevelsaboveAtitaniummeshcagecanbeplacedanteriorlyifdesired.18脊柱截骨專業(yè)知識宣講Vertebralcolumnresection（VCR）in1922byMacLennanindicatedforrigidmultiplanardeformities,

sharpangulateddeformities,emivertebraresections,resectable