Sun Lin, Song Yueming, Liu Limin, An Yonggang, Zhou Chunguang, Zhou Zhongjie
BMC Musculoskelet Disord. 2013 May 31;14:175. doi: 10.1186/1471-2474-14-175.
Widely used rod rotation and translation techniques for idiopathic scoliosis (IS) are effective in correcting spinal coronal deformity. Bilateral apical vertebral derotation technique by vertebral column manipulation (VCM) and vertebral coplanar alignment (VCA) technique are two strategies for three-dimensional (3D) correction for IS. The purpose of this study is to compare the post-surgical results and technical features of the bilateral apical vertebral derotation technique by VCM against the VCA technique in patients with Lenke type 1 IS.
Forty-eight patients with Lenke type 1 IS were enrolled in the present prospective clinical assay. They were divided into groups A (bilateral apical vertebral derotation technique by VCM, n=24) and B (VCA technique, n=24). Radiographic parameters measured before and after surgery included the Cobb angle, thoracic kyphosis, and apical vertebral rotation. Scoliosis Research Society (SRS)-22 scores were evaluated during the final follow-up. The differences in the demographics, surgical details, and radiographic measurements between the two groups were determined using a T test. The Mann-Whitney U test was used to evaluate the differences in the SRS-22 scores. A value of P<0.05 was considered statistically significant.
In the coronal plane, a significant difference was found in the correction rate of the major curve (group A: 84.8%, group B: 78.4%; P=0.045) and in the Cincinnati Correction Index between two groups (group A: 2.21, group B: 1.98; P=0.047). In the sagittal plane, no difference was found in the postoperative thoracic kyphosis between the two groups (P=0.328). In the transverse plane, no difference was found between the two groups in the correction rates of the rotation angle sagittal (P=0.298), rib hump (P=0.934), apical vertebral body-to-rib ratio (P=0.988), or apical rib spread difference (P=0.184). Patients underwent follow up for an average of 21.9 and 22.2 months in groups A and B, respectively. Results obtained at the final follow-up indicated no significant loss of correction. No differences were found in the SRS-22 scores between the two groups. No aortic or neurological complications were observed.
The 3D deformity of the spine was effectively corrected using the bilateral apical vertebral derotation technique by VCM and the VCA technique, and encouraging post-surgical results were obtained for patients with Lenke type 1 IS. The two techniques were effective in allowing 3D correctional force that was applied in different ways.
广泛应用于特发性脊柱侧凸（IS）的棒旋转和平移技术在矫正脊柱冠状面畸形方面是有效的。通过脊柱推拿（VCM）进行的双侧顶椎去旋转技术和椎体共面排列（VCA）技术是IS三维（3D）矫正的两种策略。本研究的目的是比较VCM双侧顶椎去旋转技术与VCA技术在Lenke 1型IS患者中的术后结果和技术特点。
48例Lenke 1型IS患者纳入本前瞻性临床分析。他们被分为A组（通过VCM进行双侧顶椎去旋转技术，n = 24）和B组（VCA技术，n = 24）。手术前后测量的影像学参数包括Cobb角、胸椎后凸和顶椎旋转。在最后随访时评估脊柱侧凸研究学会（SRS）-22评分。两组之间的人口统计学、手术细节和影像学测量的差异采用t检验确定。采用Mann-Whitney U检验评估SRS-22评分的差异。P<0.05被认为具有统计学意义。
在冠状面，两组在主弯矫正率（A组：84.8%，B组：78.4%；P = 0.045）和辛辛那提矫正指数方面存在显著差异（A组：2.21，B组：1.98；P = 0.047）。在矢状面，两组术后胸椎后凸无差异（P = 0.328）。在横断面，两组在矢状旋转角矫正率（P = 0.298）、肋骨隆起（P = 0.934）、顶椎椎体与肋骨比例（P = 0.988）或顶肋展开差异（P = 0.184）方面无差异。A组和B组患者分别平均随访21.9个月和22.2个月。最后随访结果显示矫正无明显丢失。两组SRS-22评分无差异。未观察到主动脉或神经并发症。
通过VCM双侧顶椎去旋转技术和VCA技术有效矫正了脊柱的3D畸形，Lenke 1型IS患者获得了令人鼓舞的术后结果。这两种技术有效地施加了以不同方式应用的3D矫正力。
