Yuan Shuo, Qiu Yong, Zhu Feng, Wang Bin, Yu Yang, Zhu Ze-zhang, Qian Bang-ping, Sun Xu, Wang Wei-jun, Ma Wei-wei
Spinal Surgery, Affiliated Gulou Hospital, Nanjing University Medical School, Nanjing 210008, China.
Zhonghua Wai Ke Za Zhi. 2011 May 1;49(5):414-8.
To investigate the effect of potential spinal growth on the posterior-only spinal instrumentation of adolescent idiopathic scoliosis (AIS).
From June 2003 to October 2007, 40 patients received posterior-only spinal instrumentation. Group of open triradiate cartilage (Group A) included 16 female AIS patients with mean age of 11.8, and group of closed triradiate cartilages (Group B) covered 24 female AIS patients with mean age of 13.7. The mean preoperative Cobb angles of Group A and B were 53.3° and 49.6° respectively, and the mean kyphosis in the sagittal plane was 27.7° and 27.8° respectively.
The post-operative Cobb angles were 22.2° (Group A) vs. 20.7° (Group B) (P = 0.34) with correction rate of 58.3% (Group A) vs. 57.7% (Group B) (P = 0.83). The mean Cobb angles at final follow-up were 24.8° (Group A) vs. 21.1° (Group B) (P = 0.05) with the correction loss of 5.3% (Group A) vs. 1.0% (Group B) (P = 0.01). In the sagittal plane, the average post-operative kyphosis was 22.5° (Group A) vs. 23.9° (Group B) (P = 0.49) with correction of 5.2° (Group A) vs. 3.9°(Group B) (P = 0.63). The mean kyphosis at final follow-up was 20.8°(Group A) vs. 24.7°(Group B) (P = 0.04) with the correction loss of -1.7° (Group A) vs. 0.8°(Group B) (P = 0.01). Group A showed obvious correction loss in the coronal plane and decrease of kyphosis in the sagittal plane. Adding on phenomenon was found in 2 cases with Lenke type I with selected fusion in Group A, but not in Group B.
Although similar post-operative correction is found in AIS patients with OTRC or CTRC, the loss of correction and "adding on phenomenon" are more likely to happen in patients with OTRC.
探讨潜在的脊柱生长对青少年特发性脊柱侧凸（AIS）单纯后路脊柱内固定术的影响。
2003年6月至2007年10月，40例患者接受单纯后路脊柱内固定术。开放三辐射软骨组（A组）包括16例女性AIS患者，平均年龄11.8岁；闭合三辐射软骨组（B组）包括24例女性AIS患者，平均年龄13.7岁。A组和B组术前Cobb角平均值分别为53.3°和49.6°，矢状面平均后凸角分别为27.7°和27.8°。
术后Cobb角A组为22.2°，B组为20.7°（P = 0.34），矫正率A组为58.3%，B组为57.7%（P = 0.83）。末次随访时Cobb角平均值A组为24.8°，B组为21.1°（P = 0.05），矫正丢失率A组为5.3%，B组为1.0%（P = 0.01）。矢状面，术后平均后凸角A组为22.5°，B组为23.9°（P = 0.49），矫正度A组为5.2°，B组为3.9°（P = 0.63）。末次随访时平均后凸角A组为20.8°，B组为24.7°（P = 0.04），矫正丢失度A组为-1.7°，B组为0.8°（P = 0.01）。A组在冠状面有明显的矫正丢失，矢状面后凸减小。A组2例Lenke I型选择性融合病例出现“附加现象”，B组未出现。
虽然OTRC或CTRC的AIS患者术后矫正相似，但OTRC患者更易发生矫正丢失和“附加现象”。
