Department of Orthopaedics, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
Spine (Phila Pa 1976). 2010 Mar 1;35(5):562-7. doi: 10.1097/BRS.0b013e3181b4af34.
Single institution, retrospective cohort study of 49 consecutive patients with Lenke I adolescent idiopathic scoliosis, all operated by a single surgeon using identical surgical technique and type of instrumentation.
To evaluate the early coronal and sagittal correction of main thoracic adolescent idiopathic scoliosis using all-pedicle screw instrumentation and to determine whether implant density influences correction.
There is an increasing trend in the use of pedicle screws in scoliosis correction surgery, particularly in using segmental all-pedicle screw constructs. No previous studies have investigated whether higher pedicle screw implant density improves correction of scoliosis in vivo.
Forty-nine consecutive patients with Lenke I main thoracic adolescent idiopathic scoliosis underwent single stage posterior correction and instrumented spinal fusion with pedicle screw fixation between 2006 and 2008. Pre- and postoperative radiographs were analyzed. Mean patient age at the time of operation was 14.4 years (range: 11-19.7 years).
The preoperative main thoracic curve of 60.0 degrees +/- 13.4 degrees was corrected to 17.4 degrees +/- 6.9 degrees (69.9% correction) on the postoperative radiographs. The preoperative thoracic kyphosis of 20.0 degrees +/- 10.2 degrees decreased to 11.6 degrees +/- 4.9 degrees after surgery. There was a significant correlation between decrease in sagittal kyphosis and magnitude of coronal Cobb angle correction (P = 0.002). There was no correlation between implant density and magnitude of coronal or sagittal curve correction, with and without curve flexibility taken into consideration.
Pedicle screw constructs provided excellent coronal correction of thoracic idiopathic scoliosis, however, this was at the expense of sagittal contour. Bilateral segmental pedicle screw fixation did not improve curve correction compared with unilateral or alternate segmental fixation.
对 49 例连续 Lenke I 型青少年特发性脊柱侧凸患者进行单机构回顾性队列研究，所有患者均由同一位外科医生采用相同的手术技术和器械进行手术。
评估全椎弓根螺钉固定治疗主胸段青少年特发性脊柱侧凸的早期冠状位和矢状位矫正效果，并确定植入物密度是否影响矫正效果。
在脊柱侧凸矫正手术中，椎弓根螺钉的使用呈增加趋势，尤其是在使用节段性全椎弓根螺钉结构时。目前尚无研究探讨更高的椎弓根螺钉植入密度是否能改善体内脊柱侧凸的矫正效果。
2006 年至 2008 年间，49 例 Lenke I 型主胸段青少年特发性脊柱侧凸患者接受了一期后路矫正和椎弓根螺钉固定的脊柱融合术。对术前和术后的 X 线片进行了分析。患者的平均手术年龄为 14.4 岁（范围：11-19.7 岁）。
术前主胸段侧凸 60.0°±13.4°，术后矫正至 17.4°±6.9°（矫正率 69.9%）。术前胸椎后凸 20.0°±10.2°，术后降至 11.6°±4.9°。矢状后凸减小与冠状 Cobb 角矫正程度呈显著相关性（P=0.002）。考虑到曲线灵活性后，植入物密度与冠状和矢状曲线矫正程度之间无相关性。
椎弓根螺钉结构为治疗特发性胸椎侧凸提供了极好的冠状位矫正效果，但这是以牺牲矢状位轮廓为代价的。双侧节段性椎弓根螺钉固定与单侧或交替节段固定相比，并没有改善曲线矫正效果。
