Sudo Hideki, Ito Manabu, Abe Yuichiro, Abumi Kuniyoshi, Takahata Masahiko, Nagahama Ken, Hiratsuka Shigeto, Kuroki Kei, Iwasaki Norimasa
*Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo, Japan; and †Eniwa Hospital, Eniwa, Japan.
Spine (Phila Pa 1976). 2014 Jun 15;39(14):1163-9. doi: 10.1097/BRS.0000000000000364.
Retrospective analysis of a prospectively collected, consecutive, nonrandomized series of patients.
To assess the surgical outcomes of the simultaneous double-rod rotation technique for treating Lenke 1 thoracic adolescent idiopathic scoliosis (AIS).
With the increasing popularity of segmental pedicle screw spinal reconstruction for treating AIS, concerns regarding the limited ability to correct hypokyphosis have also increased.
A consecutive series of 32 patients with Lenke 1 main thoracic AIS treated with the simultaneous double-rod rotation technique at our institution was included. Outcome measures included patient demographics, radiographical measurements, and Scoliosis Research Society questionnaire scores.
All 32 patients were followed up for a minimum of 2 years (average, 3.6 yr). The average main thoracic Cobb angle correction rate and the correction loss at the final follow-up were 67.8% and 3.3°, respectively. The average preoperative thoracic kyphosis (T5-T12) was 11.9°, which improved significantly to 20.5° (P < 0.0001) at the final follow-up. An increase in thoracic kyphosis was significantly correlated with an increase in lumbar lordosis at the final follow-up (r = 0.42). The average preoperative vertebral rotation angle was 19.7°, which improved significantly after surgery to 14.9° (P = 0.0001). There was no correlation between change in thoracic kyphosis and change in apical vertebral rotation (r =-0.123). The average preoperative total Scoliosis Research Society questionnaire score was 3.0, which significantly improved to 4.4 (P < 0.0001) at the final follow-up. Throughout surgery and even after, there were no instrumentation failures, pseudarthrosis, infection of the surgical site, or clinically relevant neurovascular complications.
The simultaneous double-rod rotation technique for treating Lenke 1 AIS provides significant sagittal correction of the main thoracic curve while maintaining sagittal profiles and correcting coronal and axial deformities.
对前瞻性收集的连续非随机患者系列进行回顾性分析。
评估同期双棒旋转技术治疗Lenke 1型胸段青少年特发性脊柱侧凸（AIS）的手术效果。
随着节段性椎弓根螺钉脊柱重建术治疗AIS的日益普及，对其纠正后凸不足能力有限的担忧也在增加。
纳入在我院采用同期双棒旋转技术治疗的连续32例Lenke 1型主胸弯AIS患者。观察指标包括患者人口统计学资料、影像学测量结果和脊柱侧凸研究学会问卷评分。
所有32例患者均至少随访2年（平均3.6年）。末次随访时主胸弯Cobb角平均矫正率和矫正丢失分别为67.8%和3.3°。术前胸段后凸（T5-T12）平均为11.9°，末次随访时显著改善至20.5°（P < 0.0001）。末次随访时胸段后凸增加与腰段前凸增加显著相关（r = 0.42）。术前椎体平均旋转角度为19.7°，术后显著改善至14.9°（P = 0.0001）。胸段后凸变化与顶椎旋转变化之间无相关性（r = -0.123）。术前脊柱侧凸研究学会问卷总评分平均为3.0，末次随访时显著改善至4.4（P < 0.0001）。在整个手术过程中甚至术后，均未出现内固定失败、假关节形成、手术部位感染或临床相关的神经血管并发症。
同期双棒旋转技术治疗Lenke 1型AIS可显著矫正主胸弯矢状面畸形，同时维持矢状面形态并矫正冠状面和轴面畸形。
4级。
