Wojcik A S, Webb J K, Burwell R G
Harlow Wood Orthopaedic Hospital, Nottingham, England.
Spine (Phila Pa 1976). 1990 May;15(5):424-31. doi: 10.1097/00007632-199005000-00015.
This article reports a comparison of the Cotrel-Dubousset (CD) operation with the Harrington-Luque (HL) procedure for the treatment of adolescent idiopathic thoracic scoliosis. Thirty-nine patients were studied preoperatively and postoperatively using segmental radiologic measurements including Cobb angle, end-vertebra angles (EVAs), surgical flexibility index, vertebral rotation, displacement and tilt, convex and concave rib-vertebra angles (RVAs), and kyphosis and lordosis. Cotrel-Dubousset is not significantly different from HL with respect to Cobb angle (%), surgical flexibility index, apical vertebral displacement, apical vertebral rotation, apical rib-vertebra angles, kyphosis, and lordosis. It is significantly better than the HL with respect to the correction of vertebral displacement at T10-11; lower EVA of the thoracic curve; vertebral rotation mainly above the apex; convex RVAs above the apex; and concave RVAs at T10. The surgical correction of vertebral tilt above and below the apex of the thoracic curve is significantly related to the correction of convex and concave RVAs. The view that persistent deformity of ribs is a factor needing surgical correction in some patients with adolescent idiopathic thoracic scoliosis having posterior instrumentation and fusion needs further evaluation.
本文报道了Cotrel-Dubousset（CD）手术与Harrington-Luque（HL）手术治疗青少年特发性胸段脊柱侧凸的比较。对39例患者术前和术后进行了节段性放射学测量，包括Cobb角、终椎角（EVA）、手术柔韧性指数、椎体旋转、移位和倾斜、凸侧和凹侧肋椎角（RVA）以及后凸和前凸。在Cobb角（%）、手术柔韧性指数、顶椎移位、顶椎旋转、顶椎肋椎角、后凸和前凸方面，Cotrel-Dubousset与HL无显著差异。在T10-11椎体移位的矫正、胸段曲线较低的EVA、主要在顶点上方的椎体旋转、顶点上方的凸侧RVA以及T10的凹侧RVA方面，Cotrel-Dubousset明显优于HL。胸段曲线顶点上下椎体倾斜的手术矫正与凸侧和凹侧RVA的矫正显著相关。对于一些接受后路器械固定和融合的青少年特发性胸段脊柱侧凸患者，肋骨持续畸形是需要手术矫正的一个因素，这一观点需要进一步评估。
