Wimmer Cornelius, Wallnöfer Peter, Walochnik Nadia, Krismer Martin, Saraph Vinay
Leopold Franzens University, Innsbruck, Austria.
Clin Orthop Relat Res. 2005 Oct;439:181-92. doi: 10.1097/01.blo.0000173252.95130.cb.
Surgical treatment of neuromuscular scoliosis is controversial. Owing to the presumed improvements of the newer instrumentation, we hypothesized that the Isola-Asher instrumentation would have better radiographic results that the Luque-Galveston instrumentation and that these differences would be reflected by the patients' subjective assessment of activities of daily living. We retrospectively reviewed patients with neuromuscular scoliosis who were treated using Luque-Galveston or Isola-Asher instrumentation to compare the outcomes. Preoperative, postoperative, and followup radiographs were evaluated for change in scoliosis angle, lordosis angle, and pelvic tilt. Subjective and functional results of surgery were evaluated with questionnaires. We found no difference in the degree of scoliosis correction, correction of lumbar hypolordosis or hyperlordosis, pelvic tilt, or complication rate between the two groups of patients with neuromuscular scoliosis treated with Luque-Galveston or Isola-Asher instrumentation. Patient satisfaction based on the response to the questionnaires was similar in both groups. Luque-Galveston and Isola-Asher instrumentation were comparable and equally reliable methods for surgical stabilization and correction of neuromuscular scoliosis.
神经肌肉型脊柱侧弯的手术治疗存在争议。鉴于新型器械可能带来的改善，我们推测伊索拉-阿舍器械在影像学结果上会优于卢氏-加尔维斯顿器械，并且这些差异会体现在患者对日常生活活动的主观评估中。我们回顾性分析了采用卢氏-加尔维斯顿或伊索拉-阿舍器械治疗的神经肌肉型脊柱侧弯患者，以比较治疗结果。对术前、术后及随访时的X线片进行评估，测量脊柱侧弯角度、腰椎前凸角度和骨盆倾斜度的变化。通过问卷调查评估手术的主观和功能结果。我们发现，在接受卢氏-加尔维斯顿或伊索拉-阿舍器械治疗的两组神经肌肉型脊柱侧弯患者中，脊柱侧弯矫正程度、腰椎前凸不足或前凸过度的矫正、骨盆倾斜度或并发症发生率均无差异。两组患者基于问卷回复的满意度相似。卢氏-加尔维斯顿和伊索拉-阿舍器械在神经肌肉型脊柱侧弯的手术稳定和矫正方面具有可比性且同样可靠。
