Głowacki Maciej, Misterska Ewa
Department of Paediatric Orthopaedics and Traumatology, Karol Marcinkowski University of Medical Sciences, Poznań, Poland.
Ortop Traumatol Rehabil. 2009 Nov-Dec;11(6):520-9.
To compare subjective treatment outcomes in patients with idiopathic scoliosis who underwent Cotrel-Dubousset instrumentation with rib resection at the curve apex and in patients who did not undergo rib resection at the same time as scoliosis correction.
Treatment outcomes were assessed with the Scoliosis Research Society questionnaire. The study group included 68 patients who had undergone scoliosis correction with Cotrel-Dubousset instrumentation without concurrent rib resection and 60 patients who underwent rib resection during scoliosis correction surgery using fragments of the resected ribs for posterior fusion. Mean time since surgery was 4 years 4 months in the first group, and 2 years and 6 months in the second. Mean age of patients at the time of Cotrel-Dubousset instrumentation surgery was 14 years 8 months in the first group and 15 years 6 months in the second.
There was a statistically significant difference between the two groups (in favour of the group with the rib resection) in the mean number of points per question in the overall score and the satisfaction with surgery, pain, general self-image, and post-operative function domain scores.
In the light of the SRS questionnaire, reduction of rib curve height concurrent with Cotrel-Dubousset instrumentation increased the degree of treatment satisfaction and improved patients' self-esteem without increasing back or chest pain.
比较特发性脊柱侧凸患者在接受Cotrel-Dubousset器械矫正并在侧弯顶点进行肋骨切除与在脊柱侧凸矫正时未同时进行肋骨切除的主观治疗效果。
采用脊柱侧凸研究学会问卷评估治疗效果。研究组包括68例接受Cotrel-Dubousset器械矫正且未同时进行肋骨切除的患者,以及60例在脊柱侧凸矫正手术中进行肋骨切除并使用切除肋骨碎片进行后路融合的患者。第一组术后平均时间为4年4个月,第二组为2年6个月。第一组患者接受Cotrel-Dubousset器械矫正手术时的平均年龄为14岁8个月,第二组为15岁6个月。
两组在总分中每个问题的平均得分以及对手术的满意度、疼痛、总体自我形象和术后功能领域得分方面存在统计学显著差异(有利于肋骨切除组)。
根据SRS问卷,在Cotrel-Dubousset器械矫正的同时降低肋骨侧弯高度可提高治疗满意度并改善患者自尊,而不会增加背部或胸部疼痛。