Wajanavisit W, Laohacharoensombat W
Department of Orthopaedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2000 Feb;83(2):146-50.
Eighteen patients with idiopathic scoliosis who underwent posterior spinal correction and fusion using Cotrel-Dubousset instrumentation between 1991 and 1996, were evaluated for curve correction and complications. Age at surgery averaged 14.7 years. Follow-up averaged 3.7 years. Thoracic curve correction averaged 65 per cent in those with King type III/IV curves and 51 per cent in those with King type II curves. At the recent follow-up, correction loss averaged 12 per cent and 8 per cent, respectively. Lumbar curve correction averaged 31 per cent after instrumentation in type II curves, with a loss of approximately 3 per cent correction at follow-up. Thoracic sagittal contour improved 14 degrees for hypokyphotic patients. Apical vertebral rotation improved an average of 37 per cent after derotation maneuver of the left side rod. No neurologic complications or deep infection occurred. In conclusion, frontal and sagittal thoracic curve correction can be satisfactorily achieved using Cotrel-Dubousset instrumentation.
对1991年至1996年间采用Cotrel-Dubousset器械进行后路脊柱矫正融合术的18例特发性脊柱侧凸患者的侧弯矫正情况及并发症进行了评估。手术时平均年龄为14.7岁。平均随访3.7年。King III/IV型侧弯患者的胸弯矫正平均为65%,King II型侧弯患者为51%。在最近的随访中,矫正丢失分别平均为12%和8%。II型侧弯患者在器械固定后腰椎侧弯矫正平均为31%,随访时矫正丢失约3%。胸椎矢状面轮廓在后凸不足的患者中改善了14度。左侧棒旋转操作后,顶椎旋转平均改善37%。未发生神经并发症或深部感染。总之,使用Cotrel-Dubousset器械可令人满意地实现胸弯在额状面和矢状面的矫正。