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哈灵顿棒与 Cotrel-Dubousset 器械在青少年特发性脊柱侧弯手术矫正中的比较。

Comparison of harrington rod and cotrel-dubousset devices in surgical correction of adolescent idiopathic scoliosis.

作者信息

Ameri Ebrahim, Ghandhari Hasan, Hesarikia Hamid, Rasouli Hamid Reza, Vahidtari Hossein, Nabizadeh Navid

机构信息

Department of Orthopedic Surgery, Shafa Yahyaeian Hospital, Iran University of Medical Sciences, Tehran, IR Iran.

Department of Orthopedic Surgery, Shafa Yahyaeian Hospital, Iran University of Medical Sciences, Tehran, IR Iran ; Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.

出版信息

Trauma Mon. 2013 Dec;18(3):134-8. doi: 10.5812/traumamon.14663. Epub 2013 Oct 14.

Abstract

BACKGROUND

Since the time of Paul Harrington numerous implants have been introduced for correction of scoliosis, but none are ideal. Newer devices are very expensive, and in our country some patients cannot afford them.

OBJECTIVES

The aim of this study was to compare the results of the Harrington rod (HR) device and the newer Cotrel-Dubousset (CD) device in treatment of adolescent idiopathic scoliosis (AIS).

MATERIALS AND METHODS

A retrospective review assessed patients with AIS admitted for spinal curve correction treated with HR (n = 120) and CD devices (n = 138) between October 1988 to April 2001 at the Shafa Yahyaeian Hospital, Tehran, Iran. We extracted information from the patient's file and radiographs before, after and two years post-operation.

RESULTS

The mean age of patients was 16.7 ± 2.5 years. There was no statistically significant difference between the two groups regarding gender, age, curve before surgery, and percentage of flexibility. The mean curvature was 70 ± 20.7 in the HR and 64.81 ± 19.4 in the CD group before surgery (P = 0.09); and the mean curvature was 40 ± 16.3 and 26.58 ± 15.37 in HR and CD groups respectively after surgery (P = 0.156). The mean curvature was 47.2 ± 15.9 in HR and 31.2 ± 15.4 in CD groups at two years follow-up (P = 0.156).

CONCLUSIONS

Results of many studies have shown no significant impairment in long-term quality of life and function in patients treated with Harrington rods. According to previously performed studies and the current study, surgical correction with Harrington rods seem to be comparable with the newer more expensive CD device. Although there is no doubt that the preference is to use newer devices in view of some disadvantages of HR, but this does not preclude using it for patients that cannot afford the newer devices.

摘要

背景

自保罗·哈林顿时代以来,已有多种植入物被用于矫正脊柱侧弯,但均不理想。新型器械非常昂贵,在我国一些患者无力承担。

目的

本研究旨在比较哈林顿棒(HR)器械和新型的 Cotrel-Dubousset(CD)器械治疗青少年特发性脊柱侧弯(AIS)的效果。

材料与方法

一项回顾性研究评估了1988年10月至2001年4月期间在伊朗德黑兰沙法·亚赫亚安医院接受脊柱侧弯矫正治疗的AIS患者,其中使用HR器械的患者有120例,使用CD器械的患者有138例。我们从患者病历及术前、术后和术后两年的X光片中提取信息。

结果

患者的平均年龄为16.7±2.5岁。两组在性别、年龄、术前侧弯情况和柔韧性百分比方面无统计学显著差异。术前HR组的平均弯曲度为70±20.7,CD组为64.81±19.4(P = 0.09);术后HR组和CD组的平均弯曲度分别为40±16.3和26.58±15.37(P = 0.156)。随访两年时,HR组的平均弯曲度为47.2±15.9,CD组为31.2±15.4(P = 0.156)。

结论

许多研究结果表明,接受哈林顿棒治疗的患者长期生活质量和功能无明显损害。根据先前的研究和本研究,使用哈林顿棒进行手术矫正似乎与更新的、更昂贵的CD器械效果相当。尽管鉴于HR的一些缺点,毫无疑问更倾向于使用新型器械,但这并不排除为无力承担新型器械的患者使用HR。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3a2/3864399/c13999c2273f/traumamon-18-134-i001.jpg

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