Klöckner C, Rohlmann A, Bergmann G
Department of Orthopaedics and Orthopaedic Surgery, Friedrich Alexander University Erlangen, Germany.
Biomed Tech (Berl). 2003 Dec;48(12):362-4. doi: 10.1515/bmte.2003.48.12.362.
Ventral derotation spondylodesis (VDS) is the standard in ventral scoliosis surgery. Especially in the thoracic spine, there are no alternatives to VDS with compression and derotation as its correction forces. However, pull-out of the end-vertebra screw during correction of scoliosis with the VDS implant is a common complication involving particularly the cranial end-vertebra screw in the thoracic region. This complication requires an extension of the fusion length or reduces at least the outcome of the correction. There are no in vivo data on correction forces in ventral scoliosis surgery. Thus the correction depends on the skill and experience of the surgeon. An instrumented forceps developed and built to measure forces in the longitudinal rod allows axial tensile forces to be determined in the longitudinal rod during surgery. The instrumented forceps has the advantage of reducing the risk of screw pull-out. Furthermore, viscoelastic behavior of the spine can be measured during ventral correction. In addition, knowledge of the correction forces improves our biomechanical understanding of the spine, especially during correction of scoliosis. Intraoperative force measurement is in no way detrimental to the patient.
腹侧去旋转脊柱融合术（VDS）是腹侧脊柱侧弯手术的标准术式。特别是在胸椎，以加压和去旋转作为矫正力的VDS没有其他替代方法。然而，在使用VDS植入物矫正脊柱侧弯过程中终椎螺钉拔出是一种常见并发症，尤其在胸椎区域涉及头端终椎螺钉。这种并发症需要延长融合长度或至少降低矫正效果。目前尚无关于腹侧脊柱侧弯手术矫正力的体内数据。因此，矫正取决于外科医生的技术和经验。一种为测量纵向杆中的力而开发和制造的带测量装置的钳子，可在手术过程中确定纵向杆中的轴向拉力。这种带测量装置的钳子具有降低螺钉拔出风险的优点。此外，在腹侧矫正过程中可以测量脊柱的粘弹性行为。此外，了解矫正力能增进我们对脊柱生物力学的理解，尤其是在脊柱侧弯矫正过程中。术中测力对患者毫无损害。
