Ghayem-Hasankhani Ebrahim, Omidi-Kashani Farzad
Orthopedic Research Center, Emam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Iran Red Crescent Med J. 2012 Nov;14(11):702-4. doi: 10.5812/ircmj.2554. Epub 2012 Nov 15.
Many factors effect on management (surgical and nonsurgical) of adolescent idiopathic scoliosis (AIS).
The purpose of this study was evaluation of the effects of generalized ligamentous laxity (GLL) on surgical treatment of AIS.
72 patients with AIS were studied between 2002 and 2009. 24 cases (33.4%) were placed in group A (normal) while 48 patients (66.6%) with GLL in group B. Our threshold for adding anterior approach was a curve which could not be corrected to < 50° on the supine lateral bending view.
The mean age and follow up period were 16.4 (12-22 years) and 3.8 (2-6.5 years), respectively. In the first group, 12 (50%) were operated with combined anterior and posterior approaches while in the later; there were only 6 (12.5%). Curve correction was 73.3% in patients with GLL and 57.1% in patients without it. Both of these differences were significant statistically (P = 0.001).
In preoperative planning of surgical treatment of AIS, GLL is an important factor. In this special group of patients due to much more flexibility, relatively larger scoliotic curves can be safely treated by single posterior approach.
许多因素影响青少年特发性脊柱侧凸(AIS)的治疗(手术和非手术)。
本研究旨在评估全身韧带松弛(GLL)对AIS手术治疗的影响。
2002年至2009年对72例AIS患者进行研究。24例(33.4%)被归入A组(正常),而48例(66.6%)有GLL的患者被归入B组。我们增加前路手术的阈值是在仰卧位侧弯视图上不能矫正到<50°的曲线。
平均年龄和随访时间分别为16.4岁(12 - 22岁)和3.8年(2 - 6.5年)。在第一组中,12例(50%)采用前后联合入路手术,而在第二组中,只有6例(12.5%)。有GLL的患者曲线矫正率为73.3%,无GLL的患者为57.1%。这两个差异均具有统计学意义(P = 0.001)。
在AIS手术治疗的术前规划中,GLL是一个重要因素。在这组特殊患者中,由于柔韧性更强,相对较大的脊柱侧凸曲线可以通过单纯后路手术安全治疗。