Canavese Federico, Dimeglio Alain, Volpatti Donatella, Stebel Marco, Daures Jean-Pierre, Canavese Bartolomeo, Cavalli Fabio
Service de Chirurgie Orthopédique Pédiatrique, CHU Hôpital Lapeyronie, Montpellier, France.
Spine (Phila Pa 1976). 2007 Jul 15;32(16):E443-50. doi: 10.1097/BRS.0b013e3180bc2340.
Dorsal arthrodesis of thoracic spine in a prepubertal New Zealand White rabbit model.
Evaluating the consequences of dorsal arthrodesis on the growth of the spine, sternum, and thorax in prepubertal rabbits, through the study of CT scans.
Vertebral arthrodesis in the treatment of progressive idiopathic scoliosis in prepubertal patients is not ideal, but is still a choice in treating major deformities of the spine. Postoperative assessment of spinal deformity is essential, feasible, and recordable through CT scans.
Twelve female rabbits, 9 weeks old, were subjected to surgery for dorsal arthrodesis of the upper thoracic spine. Surgery involved the implant of 2 "C"-shaped titanium bars, which were placed beside the spinous processes of the thoracic vertebrae. Three CT scans were performed, 10 (T1), 55 (T2), and 139 (T3) days after surgery. Measures were obtained by Myrian Pro software for 3 different groups: G1 with complete fusion, G2 with incomplete fusion, and G3 sham-operated.
The average of the dorsoventral/laterolateral thoracic diameter ratio at fused levels is lower than 1 in G1 as well as in G2; on the contrary, in G3 is higher than 1. The average growth of the sternum length between T1 and T2 and between T2 and T3 is minor in G1 than in G2 and G3. The dorsal and ventral lengths of thoracic vertebral bodies in the spinal segment D1-D6 is smaller in G1 and G2 than in G3, whereas no differences were observed between the 3 groups in the D7-D12 segment without arthrodesis.
Dorsal arthrodesis in prepubertal rabbits changes thoracic growth patterns. In operated rabbits, the dorsoventral thoracic diameter grows more slowly than the laterolateral thoracic diameter. The sternum as well as the lengths of thoracic vertebral bodies in the spinal segment D1-D6 grow less. The crankshaft phenomenon is evident at the fused vertebral levels where there is a reduction of thoracic kyphosis.
在青春期前新西兰白兔模型中进行胸椎后路融合术。
通过CT扫描研究，评估青春期前兔胸椎后路融合术对脊柱、胸骨和胸廓生长的影响。
青春期前患者行椎体融合术治疗进行性特发性脊柱侧弯并不理想，但仍是治疗脊柱严重畸形的一种选择。脊柱畸形的术后评估至关重要、可行且可通过CT扫描记录。
12只9周龄雌性兔接受上胸椎后路融合术。手术包括植入2根“C”形钛棒，置于胸椎棘突旁。术后10（T1）、55（T2）和139（T3）天进行三次CT扫描。通过Myrian Pro软件对三个不同组进行测量：G1组为完全融合，G2组为不完全融合，G3组为假手术组。
G1组和G2组融合节段的胸段前后径/左右径平均比值低于1；相反，G3组高于1。G1组胸骨长度在T1和T2之间以及T2和T3之间的平均生长幅度小于G2组和G3组。G1组和G2组脊柱节段D1-D6的胸椎体背侧和腹侧长度小于G3组，而在未进行融合的D7-D12节段，三组之间未观察到差异。
青春期前兔胸椎后路融合术改变胸廓生长模式。在手术兔中，胸段前后径的生长比左右径更慢。胸骨以及脊柱节段D1-D6的胸椎体长度生长较少。在融合椎体节段，曲轴现象明显，胸段后凸减小。
