Bhojraj Shekhar Y, Varma Raghuprasad G, Nene Abhay M, Mohite Sheetal
Consultant Spine Surgeon, Lilavati Hospital and MRC and Breach Candy Hospital, Mumbai, India.
Indian J Orthop. 2010 Jan;44(1):50-6. doi: 10.4103/0019-5413.58606.
Most literature popularizes the efficacy of third generation instrumentation in the surgical correction of spinal deformities. A cheap and effective scoliotic deformity correction method is reviewed in this article. The aim of this study is to evaluate the efficacy of spinal loop rectangle and sub laminar wires as a modality for spinal deformity correction and its co-relation with patients' satisfaction and clinical outcome.
Thirty six patients of scoliotic spinal deformities with various etiologies (congenital-4, idiopathic- 25, neurofibromatosis-3, neuromuscular-2 and 'syndromic'-3) with ages ranging from 8 to 23 years underwent corrective posterior spinal arthrodesis with stainless steel Hartshill loop rectangle and sublaminar wires. Clinicoradiological evaluation was done at an average follow-up of 6 (1/2) years (min-2 (1/2), years). Along with clinicoradiological outcome, patient satisfaction (as per the SRS 24), was accounted.
Average preoperative Cobb's angle were 73.25 degrees in the entire group and 66.48 degrees in the idiopathic group. Average percentage correction was 64.34% in the entire group and the (average degree of correction was 47.13). In the idiopathic group, the respective values were 69.19% and 46 degrees . Loss of correction in the whole group was 2.2 degrees at two year follow up. Sagittal profiles, truncal balance were well corrected too; minimal complications were seen. Patient satisfaction results were encouraging in 36 patients as per - SRS24). About 80.2% patients were ready to undergo the same surgery if required. (SRS24).
Segmental spinal fixation with locally made spinal loop rectangle and sublaminar wires is comparable as a modality to correct scoliotic spinal deformities.
大多数文献都在宣传第三代器械在脊柱畸形手术矫正中的疗效。本文回顾了一种廉价且有效的脊柱侧弯畸形矫正方法。本研究的目的是评估脊柱环矩形和椎板下钢丝作为脊柱畸形矫正方式的疗效及其与患者满意度和临床结果的相关性。
36例不同病因（先天性4例、特发性25例、神经纤维瘤病3例、神经肌肉性2例和综合征性3例）的脊柱侧弯畸形患者，年龄在8至23岁之间，接受了使用不锈钢哈特希尔环矩形和椎板下钢丝的后路脊柱矫正融合术。平均随访6.5年（最短2.5年）时进行临床放射学评估。除了临床放射学结果外，还统计了患者满意度（根据SRS 24）。
整个组术前平均 Cobb 角为73.25度，特发性组为66.48度。整个组平均矫正百分比为64.34%（平均矫正度数为47.13）。在特发性组中，相应的值分别为69.19%和46度。两年随访时整个组的矫正丢失为2.2度。矢状面轮廓、躯干平衡也得到了很好的矫正；并发症极少。根据SRS24，36例患者的患者满意度结果令人鼓舞。约80.2%的患者表示如果需要愿意接受相同的手术。（SRS24）
使用自制的脊柱环矩形和椎板下钢丝进行节段性脊柱固定作为矫正脊柱侧弯畸形的一种方式具有可比性。
