Lenke L G, Bridwell K H, Baldus C, Blanke K
Division of Orthopedic Surgery, Washington University School of Medicine, St. Louis, Missouri 63110.
J Spinal Disord. 1992 Mar;5(1):16-25. doi: 10.1097/00002517-199203000-00003.
Forty-eight patients with idiopathic scoliosis underwent posterior spinal fusion with Cotrel-Dubousset instrumentation (CDI). Each patient was given preoperative and postoperative pulmonary function tests (PFTs). Pulmonary volume improved a mean 0.40 L (16%), and pulmonary flow improved a mean 0.33 L (15%). Differences between preoperative and postoperative PFT values were shown to be statistically significant and correlated well with coronal side-bending correction. Twenty patients had preoperative and postoperative CT scans through the apical vertebra. Vertebral rotation was assessed on CT scan by the method of Aaro and Dahlborn (1,2). At the apex, the mean percentage improvements in the longitudinal axis rotation relative to the midline (16%) and to the sagittal plane (10%), the rib hump index (8%), and the kyphosis-lordosis index (0%) were minimal. Radiographically, the 66% mean improvement in apical vertebral translation was more substantial and consistent than the 10% mean improvement in apical vertebral rotation. Therefore, at the apex the CDI "derotation maneuver" may be more of a "translational maneuver."
48例特发性脊柱侧凸患者接受了Cotrel-Dubousset器械（CDI）后路脊柱融合术。每位患者均进行了术前和术后肺功能测试（PFT）。肺容积平均改善0.40L（16%），肺流量平均改善0.33L（15%）。术前和术后PFT值之间的差异具有统计学意义，且与冠状面侧弯矫正密切相关。20例患者在术前和术后通过顶椎进行了CT扫描。通过Aaro和Dahlborn的方法（1,2）在CT扫描上评估椎体旋转。在顶点处，相对于中线的纵轴旋转平均改善百分比（16%）、相对于矢状面的纵轴旋转平均改善百分比（10%）、肋骨隆突指数（8%）和后凸-前凸指数（0%）的改善幅度最小。影像学上，顶椎平移平均66%的改善比顶椎旋转平均10%的改善更显著且更一致。因此，在顶点处，CDI的“去旋转操作”可能更多地是一种“平移操作”。
