Lowenstein Jason E, Matsumoto Hiroko, Vitale Michael G, Weidenbaum Mark, Gomez Jaime A, Lee Francis Young-In, Hyman Joshua E, Roye David P
Morgan Stanley Children's Hospital of New York Presbyterian, Columbia University Medical Center, New York, NY, USA.
Spine (Phila Pa 1976). 2007 Feb 15;32(4):448-52. doi: 10.1097/01.brs.0000255030.78293.fd.
This was a retrospective cohort study using a previously matched convenience sample of 34 patients.
This study sought to determine the relative corrective benefits of these 2 types of constructs in the correction of coronal and sagittal curves in patients with adolescent idiopathic scoliosis (AIS). In addition, the 2 constructs were compared for coronal and sagittal balance.
Recent clinical research suggests that thoracic pedicle screw constructs (all-screw constructs) are more effective than hybrid lumbar screw thoracic hook constructs (hybrid constructs) in correcting spine deformity.
The sample consisted of patients with AIS who underwent isolated posterior spinal fusion and instrumentation. Seventeen patients underwent fusion using all-screw constructs, and 17 underwent fusion with hybrid constructs; preoperative and postoperative radiographs and measurements were compared.
There was no significant difference observed when comparing the 2 groups, although there was a trend toward better correction of the main thoracic curve in the all-screw construct group (P = 0.089). In the all-screw group, mean thoracic kyphosis decreased from 29.6 degrees to 19.4 degrees (P = 0.012). Sagittal balance changed in the hybrid group from -21.2 mm to 8.2 mm, and in the all-screw group changed from -28.8 mm to 1.5 mm. The major curve in the hybrid group improved from 54.06 degrees to 20.25 degrees and improved from 54.88 degrees to 15.06 degrees in the all-screw group.
There was no statistically significant difference comparing the 2 groups, although a trend was observed toward better correction of the main thoracic curve in the all-screw construct group. The all-screw group demonstrated a significant decrease in kyphosis, which was not seen in the hybrid group. Hybrid constructs were comparable to all-screw constructs in the correction of coronal plane deformity and sagittal balance.
这是一项回顾性队列研究，使用了之前匹配的34例患者的便利样本。
本研究旨在确定这两种类型的固定装置在矫正青少年特发性脊柱侧凸（AIS）患者的冠状面和矢状面曲线方面的相对矫正效果。此外，还对这两种固定装置的冠状面和矢状面平衡进行了比较。
最近的临床研究表明，胸椎椎弓根螺钉固定装置（全螺钉固定装置）在矫正脊柱畸形方面比混合腰椎螺钉胸椎钩固定装置（混合固定装置）更有效。
样本包括接受单纯后路脊柱融合和内固定的AIS患者。17例患者使用全螺钉固定装置进行融合，17例患者使用混合固定装置进行融合；比较术前和术后的X线片及测量数据。
比较两组时未观察到显著差异，尽管全螺钉固定装置组在主胸弯矫正方面有更好的趋势（P = 0.089）。在全螺钉组中，平均胸椎后凸从29.6度降至19.4度（P = 0.012）。矢状面平衡在混合组中从 -21.2 mm变为8.2 mm，在全螺钉组中从 -28.8 mm变为1.5 mm。混合组的主弯从54.06度改善至20.25度，全螺钉组从54.88度改善至15.06度。
比较两组时无统计学显著差异，尽管全螺钉固定装置组在主胸弯矫正方面有更好的趋势。全螺钉组的后凸明显降低，混合组未出现这种情况。混合固定装置在矫正冠状面畸形和矢状面平衡方面与全螺钉固定装置相当。
