Trobisch P D, Samdani A, Cahill P, Betz R R
Dept. of Orthopedics, Shriners Hospital for Children, 3551 N Broad Street, Philadelphia, PA 19140, USA.
Oper Orthop Traumatol. 2011 Jul;23(3):227-31. doi: 10.1007/s00064-011-0032-z.
Unilateral vertebral body stapling as a fusionless alternative to control curvature progression in patients with idiopathic scoliosis (IS).
Skeletally immature patients (Risser 0 or 1) with IS measuring 20-45° and correction of the curvature <20° on side-bending X-rays.
Congenital scoliosis, curvature above T4 or below L4, thoracic kyphosis >40°.
Unilateral disc-sparing staples are placed at the convex side. A thoracoscopic approach can be used for thoracic curves and a mini-open retroperitoneal approach for lumbar curves.
Early ambulation on postoperative day 1 is encouraged. There are no absolute activity restrictions, and no bracing beyond 4 weeks is required.
A total of 28 patients (4 males, 24 females; average age at operation 9.4 years) met all inclusion criteria and had a minimum 2-year follow-up (range 2-5.3 years). The success rate (improvement or stabilization of the curvature) was 86% for thoracic curves <35° and all lumbar curves meeting the indications.
单侧椎体钉合术作为一种非融合手术，用于控制特发性脊柱侧凸（IS）患者的侧弯进展。
骨骼未成熟的IS患者（Risser 0或1级），侧弯角度为20 - 45°，侧位X线片上侧弯矫正度<20°。
先天性脊柱侧凸、胸4以上或腰4以下侧弯、胸椎后凸>40°。
在凸侧放置单侧保留椎间盘的钉合器。胸段侧弯可采用胸腔镜入路，腰段侧弯可采用小切口腹膜后入路。
鼓励术后第1天早期下床活动。没有绝对的活动限制，术后4周后无需支具固定。
共有28例患者（4例男性，24例女性；平均手术年龄9.4岁）符合所有纳入标准，且至少随访2年（范围2 - 5.3年）。胸段侧弯<35°且所有符合适应症的腰段侧弯的成功率（侧弯改善或稳定）为86%。
