Cotrel-Dubousset与Colorado器械用于特发性脊柱侧凸矫正的三维放射学比较
A three-dimensional radiographic comparison of Cotrel-Dubousset and Colorado instrumentations for the correction of idiopathic scoliosis.
作者信息
Delorme S, Labelle H, Aubin C E, de Guise J A, Rivard C H, Poitras B, Dansereau J
机构信息
Research Center, Sainte-Justine Hospital, Montréal, Québec, Canada.
出版信息
Spine (Phila Pa 1976). 2000 Jan 15;25(2):205-10. doi: 10.1097/00007632-200001150-00010.
STUDY DESIGN
A prospective clinical study comparing two instrumentation systems for the correction of idiopathic scoliosis.
OBJECTIVES
To measure the short-term three-dimensional changes in the shape of the spine after corrective surgery and compare the Cotrel-Dubousset instrumentation to the more recent Colorado instrumentation to determine whether one system provides better three-dimensional correction.
SUMMARY OF BACKGROUND DATA
Adequate three-dimensional correction of scoliotic deformities has been reported with the Cortrel-Dubousset instrumentation system. During the past decade, a new generation of more versatile and user-friendly spinal implants has appeared, but there are no reports available to indicate whether similar or better correction can be obtained with these newer systems.
METHODS
The three-dimensional geometry of the thoracic and lumbar spine was documented in the standing position using a three-dimensional reconstruction technique based on multiplanar radiography in 67 adolescents with idiopathic scoliosis undergoing correction by a posterior approach. Changes in spinal shape were measured 3 days before and 1 month after the surgery in 31 patients with Cotrel-Dubousset instrumentation and 36 patients with Colorado instrumentation.
RESULTS
In both groups, adequate three-dimensional correction of the scoliotic deformities was documented for thoracic and lumbar curves, with significant changes in the frontal plane, in the plane of maximum curvature, and in its orientation. When comparing both groups, better correction was obtained in the frontal plane with the Colorado instrumentation (65% vs. 48% with Cotrel-Dubousset), a finding that may be explained by the significantly greater proportion of pedicle screws used in this group.
CONCLUSION
Both instrumentation techniques achieve an effective and comparable three-dimensional correction of the scoliotic deformities.
研究设计
一项前瞻性临床研究，比较两种用于矫正特发性脊柱侧凸的器械系统。
目的
测量矫正手术后脊柱形状的短期三维变化，并将Cotrel-Dubousset器械与更新的科罗拉多器械进行比较，以确定一种系统是否能提供更好的三维矫正。
背景数据总结
据报道，Cortrel-Dubousset器械系统能对脊柱侧凸畸形进行充分的三维矫正。在过去十年中，出现了新一代更通用、更便于使用的脊柱植入物，但尚无报告表明使用这些更新的系统能否获得相似或更好的矫正效果。
方法
采用基于多平面X线摄影的三维重建技术，记录67例接受后路矫正的特发性脊柱侧凸青少年患者站立位时胸腰椎的三维几何形态。在31例使用Cotrel-Dubousset器械和36例使用科罗拉多器械的患者中，分别在手术前3天和术后1个月测量脊柱形状的变化。
结果
两组患者的胸腰段曲线均实现了对脊柱侧凸畸形的充分三维矫正，在额状面、最大曲率平面及其方向上均有显著变化。比较两组时，科罗拉多器械在额状面的矫正效果更好（65%对Cotrel-Dubousset的48%），这一结果可能是由于该组使用椎弓根螺钉的比例显著更高。
结论
两种器械技术均能对脊柱侧凸畸形实现有效且可比的三维矫正。
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