Li Ming, Shen Yu, Fang Xiutong, Ni Jianqiang, Gu Suxi, Zhu Xiaodong, Zhang Zhiyu
Department of Orthopedics, Changhai Hospital, Second Military Medical University, Yangpu District, Shanghai, China.
J Spinal Disord Tech. 2009 Jun;22(4):251-6. doi: 10.1097/BSD.0b013e3181884940.
Prospective clinical study.
The aim of this study was to compare postoperative outcome in patients with Lenke 1 adolescent idiopathic scoliosis (AIS) after posterior correction and fusion with consecutive or interval pedicle screw constructs on the correction side.
Despite reports of satisfactory correction and maintenance of scoliotic curves after consecutive pedicle screw instrumentation on the correction side, there has been no comparison of outcome after consecutive versus interval pedicle screw placement.
Thirty patients with Lenke 1 AIS were randomly divided into 2 groups. In 1 group, posterior fusion was performed using consecutive pedicle screw placement on the correction side, whereas in the other, an interval placement construct was employed. The following variables were assessed preoperatively and postoperatively (between 2 and 4.1 y) to ascertain curve correction: thoracic coronal and sagittal Cobb angle and global coronal and sagittal balance.
There were no preoperative or surgical between group differences for any variable. Thoracic coronal Cobb angle significantly decreased from 60.7+/-11.7 to 15.5+/-7.88 and from 61.87+/-9.93 to 15.67+/-7.35 in the consecutive and interval placement groups. Thoracic sagittal Cobb angle significantly decreased from 27.3+/-10.6 to 21.5+/-11.7 and from 27.1+/-9.83 to 22.0+/-11.3 in the consecutive and interval placement groups. Global sagittal balance significantly decreased from -2.33+/-5.05 to 1.33+/-3.22 and from -3.40+/-4.76 to 0.80+/-2.93 in the consecutive and interval placement groups. There were no between group differences for any postoperative measure. No neurologic complications of surgery were apparent in either group.
Interval pedicle screw placement constructs seem to be equally effective as consecutive constructs for facilitating curve correction in patients with Lenke 1 AIS.
前瞻性临床研究。
本研究旨在比较Lenke 1型青少年特发性脊柱侧凸（AIS）患者在后路矫正融合术后，使用连续或间隔椎弓根螺钉固定于矫正侧的术后结果。
尽管有报道称在矫正侧使用连续椎弓根螺钉内固定后，脊柱侧凸曲线矫正效果良好且维持稳定，但连续与间隔椎弓根螺钉置入后的结果尚无比较。
30例Lenke 1型AIS患者随机分为2组。一组在矫正侧使用连续椎弓根螺钉置入进行后路融合，另一组采用间隔置入固定。术前及术后（2至4.1年）评估以下变量以确定曲线矫正情况：胸段冠状面和矢状面Cobb角以及整体冠状面和矢状面平衡。
两组间术前及手术相关的任何变量均无差异。连续置入组和间隔置入组的胸段冠状面Cobb角分别从60.7±11.7显著降至15.5±7.88以及从61.87±9.93显著降至15.67±7.35。连续置入组和间隔置入组的胸段矢状面Cobb角分别从27.3±10.6显著降至21.5±11.7以及从27.1±9.83显著降至22.0±11.3。连续置入组和间隔置入组的整体矢状面平衡分别从-2.33±5.05显著降至1.33±3.22以及从-3.40±4.76显著降至0.80±2.93。两组术后的任何测量指标均无差异。两组均未出现明显的手术神经并发症。
对于Lenke 1型AIS患者，间隔椎弓根螺钉置入固定在促进曲线矫正方面似乎与连续固定同样有效。
