Department of Orthopaedics, Changhai Hospital Affiliated by Second Military Medical University, Shanghai, China.
Orthop Surg. 2009 Feb;1(1):6-11. doi: 10.1111/j.2757-7861.2008.00002.x.
To prospectively evaluate the clinical and radiographic effects of posterior surgery with wide posterior shortening release and segmental pedicle screws techniques in a consecutive group of patients with thoracolumbar /lumbar adolescent idiopathic scoliosis.
Between April 2002 and July 2005, 114 patients (86 women and 28 men) were enrolled in this study. There were 72 Lenke type 5, 32 Lenke type 6, and 10 Lenke type 3C curves. Radiographic parameters such as coronal plane Cobb angle; lordosis angle; lowest instrumented vertebrae (LIV) angulation; and the distances from the central sacral vertical line (CSVL) to the LIV, to the apical vertebra and to the C7 plumb line, were analyzed. Complication rates were also recorded during follow-up.
The average coronal correction was from 61° to 13° (78.6%). In the sagittal plane, lumbar lordosis was normalized from 36° with a wide range (23°-67°) to 42° with a normal range (34°-55°). The LIV had 79% correction of coronal angulations. The center sacral line to LIV was improved from 2.3 cm to 0.5 cm, apex to center sacral line from 5.0 cm to 1.6 cm, and CSVL from 2.7 cm to 0.8 cm. A total of 1460 pedicle screws were placed safely, average 9.6 levels (5-14) were fused. The patients were followed up for an average of 30 months (range, 12-50). There was excellent maintenance of correction at final follow-up.
Wide posterior release and segmental pedicle screw instrumentation has excellent radiographic and clinical results with minimal complications.
前瞻性评估后路广泛后方缩短松解和节段性椎弓根螺钉技术在连续一组胸腰椎/腰椎青少年特发性脊柱侧凸患者中的临床和影像学效果。
2002 年 4 月至 2005 年 7 月，共纳入 114 例患者（86 例女性，28 例男性）。其中 Lenke 5 型 72 例，Lenke 6 型 32 例，Lenke 3C 型 10 例。分析冠状面 Cobb 角、脊柱前凸角、最低置钉椎（LIV）角度以及 CSA 到 LIV、到顶椎、到 C7 铅垂线的距离等影像学参数。并记录随访期间的并发症发生率。
平均冠状面矫正率为 61°至 13°（78.6%）。在矢状面，腰椎前凸从大范围的 36°（23°-67°）正常化为 42°（34°-55°）。LIV 的冠状面角度矫正率为 79%。CSA 到 LIV 从 2.3cm 改善至 0.5cm，顶椎到 CSA 从 5.0cm 改善至 1.6cm，CSA 到 C7 铅垂线从 2.7cm 改善至 0.8cm。总共安全放置了 1460 枚椎弓根螺钉，平均融合 9.6 个节段（5-14 个）。患者平均随访 30 个月（12-50 个月）。最终随访时矫正效果保持良好。
后路广泛松解和节段性椎弓根螺钉固定具有极佳的影像学和临床效果，并发症发生率低。
