Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Spine (Phila Pa 1976). 2011 Jun 15;36(14):1123-30. doi: 10.1097/BRS.0b013e3181f9a07a.
Prospective case series.
To evaluate the clinical and radiologic outcomes of short segment anterior scoliosis surgery with bone-on-bone apposition using a dual screw, dual rod system.
Posterior segmental fixation for correction of AIS involves instrumentation of all the vertebrae included in the major curve. Our short segment anterior technique produces similar results by fusion of fewer levels.
Forty-five patients operated between 1996 and 2004. Twenty-eight thoracic (Lenke 1) and 17 thoracolumbar (Lenke 5). The mean age was 19 years, 87% were females, and the mean follow-up was 72 months (range 28-121 months). We operated on curves less than 85° with "total discectomy," bone-on-bone apposition, and dual-screw, dual-rod fixation.
A mean of five vertebrae (four discs) were instrumented, with a mean operative time of 360 minutes, blood loss of 877 mL and a hospital stay of 9.1 day. Lenke 1. The main preop thoracic curve was 52.5°, final postop curve 27.9°, by fusing five vertebrae, four discs. A spontaneous improvement of 47.5% of the lumbar compensatory curve was seen. The lower tilt angle corrected from 20.9° to 11°. Lenke 5. The preoperative thoracolumbar major curve corrected from 50.5° to 18.3° (final) with fusion of four vertebrae, three discs. A spontaneous improvement of 37.4% occurred in the thoracic compensatory curve. The preop tilt angle improved from 27.7° to 8.3°.The sagittal and coronal balance was restored in all the patients. There were no neurologic, vascular, pulmonary, or implant-related complications. Union occurred within 3 months. All the patients returned to an unrestricted lifestyle within 4 months.
We report good results after surgical correction using our short segment bone-on-bone technique. Improvements were noted and maintained, over a 6-year period.
前瞻性病例系列研究。
评估使用双螺钉、双棒系统进行骨对骨贴合的短节段前路脊柱侧凸手术的临床和影像学结果。
后路节段性固定矫正 AIS 涉及融合所有主要曲度包含的椎体。我们的短节段前路技术通过融合较少的节段产生相似的结果。
1996 年至 2004 年间共 45 例患者接受手术。28 例为胸段（Lenke1 型），17 例为胸腰椎段（Lenke5 型）。平均年龄为 19 岁，87%为女性，平均随访时间为 72 个月（28-121 个月）。我们对小于 85°的曲度进行手术，采用“全椎间盘切除”、骨对骨贴合和双螺钉、双棒固定。
平均融合 5 个椎体（4 个椎间盘），手术时间 360 分钟，失血量 877ml，住院时间 9.1 天。Lenke1 型。术前主胸弯 52.5°，最终术后胸弯 27.9°，融合 5 个椎体，4 个椎间盘。腰椎代偿性曲线自发性改善 47.5%。下倾斜角从 20.9°矫正至 11°。Lenke5 型。术前胸腰椎主弯从 50.5°矫正至 18.3°（终末），融合 4 个椎体，3 个椎间盘。胸椎代偿性曲线自发性改善 37.4%。术前倾斜角从 27.7°改善至 8.3°。所有患者的矢状面和冠状面平衡均得到恢复。无神经、血管、肺部或植入物相关并发症。3 个月内融合。所有患者在 4 个月内恢复无限制的生活方式。
我们报告了使用短节段骨对骨技术进行手术矫正后的良好结果。在 6 年的随访中，观察到并维持了改善。
