Barbanti Brodano G, Martikos K, Vommaro F, Greggi T, Boriani S
Department of Oncological and Degenerative Spine Surgery, Rizzoli Orthopedic Institute, Bologna, Italy.
Eur Rev Med Pharmacol Sci. 2014;18(1 Suppl):24-8.
Minimally invasive spine surgery (MISS) has become popular during the last decade due to continuous evidence in favor of lesser soft tissue damage, faster recovery, higher patient satisfaction and reduced health costs. During the last years, surgical ambition for better results as well as most detailed knowledge of spinal anatomy, have resulted in the continuous and successful expansion of indications of MISS, covering already successfully a wide range of degenerative spinal pathologies as well as adult spinal deformities.
We describe here a case report of a patient with adolescent idiopathic scoliosis (AIS) treated by minimally invasive posterior pedicle screw instrumentation.
We report the case of an 18 years old female patient affected by AIS, Lenke type 1AN, with a 65 degree right thoracic curve and severe rib hump. Posterior pedicle screw instrumentation as well as corrective manoeuvres were performed exclusively by minimally invasive procedure, through three small midline skin incisions.
We obtained a good clinical and radiographical correction of scoliosis, which was maintained during the follow-up period. We also observed a limited intra-operative blood loss, a limited operative time, limited pain, earlier mobilization and limited hospital stay.
A minimally invasive technique can be used for the surgical treatment of AIS, showing satisfying deformity correction and multiple perceived advantages, although long-term data are needed before this kind of surgery can be recommended for routine use.
在过去十年中,微创脊柱手术(MISS)已变得流行,这是因为不断有证据表明其对软组织的损伤较小、恢复更快、患者满意度更高且医疗成本更低。在过去几年中,追求更好手术效果的目标以及对脊柱解剖结构的详尽了解,使得MISS的适应证不断成功扩展,现已成功涵盖了广泛的退行性脊柱疾病以及成人脊柱畸形。
我们在此描述一例采用微创后路椎弓根螺钉内固定术治疗的青少年特发性脊柱侧凸(AIS)患者的病例报告。
我们报告一例18岁女性AIS患者,Lenke 1AN型,右胸弯65度且伴有严重肋骨隆起。后路椎弓根螺钉内固定及矫正操作均通过三个小的中线皮肤切口,仅采用微创手术完成。
我们在临床上和影像学上均获得了良好的脊柱侧凸矫正效果,且在随访期间得以维持。我们还观察到术中失血有限、手术时间有限、疼痛有限、早期活动以及住院时间有限。
微创技术可用于AIS的手术治疗,显示出令人满意的畸形矫正效果及多种明显优势,不过在推荐此类手术常规应用之前,还需要长期数据。