Orthopédie infantile, hôpital Saint-Vincent-de-Paul, 74, avenue Denfert-Rochereau, 75014 Paris, France.
Orthopédie infantile, hôpital Saint-Vincent-de-Paul, 74, avenue Denfert-Rochereau, 75014 Paris, France.
Orthop Traumatol Surg Res. 2014 Feb;100(1):37-41. doi: 10.1016/j.otsr.2013.12.009. Epub 2014 Jan 18.
The authors have designed a new method of instrumentation aimed at obtaining surgical fixation of the scoliotic curve without any postoperative external immobilisation. It is particularly strong and rigid and allows adequate reduction of the curve. This technique avoids the sublaminar space and thus prevents excessive blood loss and diminishes the danger of cord damage. The instrumentation is made of two parallel rough cylindrical rods inserted independently in the convexity and concavity of the curve. If necessary, they can be bent pre-operatively. They are attached to hooks placed on the laminae or pedicles, which are locked by bolts, thus allowing progressive straightening of the curve. They are joined by two transverse bars, one above and one below, to provide better rigidity to the device and to allow correction of rotation. The parts of the vertebrae left free by the device are denuded to allow the addition of grafts. Laboratory tests have demonstrated that this type of fixator is more rigid than the Harrington or Luque rods. Fifteen patients, either idiopathic or paralytic cases, were operated on without any neurological impairment. No loss of correction was observed since the hooks have been locked.
作者设计了一种新的器械固定方法,旨在获得脊柱侧凸的手术固定,而无需任何术后外固定。它特别坚固和刚性,允许充分减少曲线。该技术避免了椎板下间隙,从而防止过度失血,并降低脊髓损伤的危险。器械由两根平行的粗糙圆柱形杆组成,分别插入曲线的凸面和凹面。如果需要,它们可以在术前弯曲。它们连接到放置在椎板或椎弓根上的钩子上,通过螺栓锁定,从而允许逐渐拉直曲线。通过两根横向杆连接在一起,上面一根,下面一根,以提高装置的刚性并允许矫正旋转。器械留下的自由椎体部分被裸露,以允许添加移植物。实验室测试表明,这种类型的固定器比哈林顿或鲁克棒更坚固。15 名特发性或麻痹性患者接受了手术,没有任何神经损伤。由于钩子已锁定,因此没有发现矫正丢失。