Sales de Gauzy Jérôme, Jouve Jean-Luc, Ilharreborde Brice, Blondel Benjamin, Accadbled Franck, Mazda Keyvan
Department of Pediatric Orthopaedics, Service d'Orthopédie Pédiatrique, Hôpital des Enfants, 330, avenue de Grande Bretagne, 31059, Toulouse Cedex 9, France,
Eur Spine J. 2014 Jul;23 Suppl 4:S446-51. doi: 10.1007/s00586-014-3341-8. Epub 2014 May 15.
The Universal Clamp (UC) equipped with a soft sublaminar band is a relatively new thoracic anchor that can be used in hybrid constructs. A dedicated reduction tool that applies traction to the sublaminar band permits gentle translation of the thoracic curve to the pre-contoured fusion rods, which have been previously anchored distally by pedicle screws and proximally by hooks in a claw configuration.
A literature review concerning the use of UC in adolescent idiopathic Scoliosis was performed.
The results confirm the efficacy with the UC hybrid constructs, the good correction (71-66%) of the main thoracic curve and low loss of correction at 2-year follow-up (3-4%). The thoracic curve correction achieved and maintained in the AIS patients appears to be substantially higher than that reported for all hook and hook hybrid techniques. Regardless of the deformity correcting method employed with all-screw constructs, the Cobb angle correction achieved is equivalent to that achieved with UC hybrid devices. Among the present AIS patients who had normal values of thoracic kyphosis pre-operatively, there was almost no change in average thoracic kyphosis at the latest follow-up. However, among the patients with low pre-operative values of T5-T12 kyphosis, the average T5-T12 kyphosis improved.
Hybrid construct with UC is safe, with reduced operative time and blood loss. While achieving deformity correction in the coronal and axial planes equivalent to the best-reported results of all screw or previous hybrid constructs, the UC hybrid technique appears to provide superior correction in the sagittal plane. The excellent outcome is maintained at the 2-year follow-up.
配备柔软椎板下带的通用夹（UC）是一种相对较新的胸椎固定器，可用于混合结构。一种专门的复位工具，可对椎板下带施加牵引力，能使胸椎曲线轻柔地平移至预塑形的融合棒上，这些融合棒先前已通过椎弓根螺钉在远端和钩在近端以爪形配置进行固定。
对UC在青少年特发性脊柱侧凸中的应用进行了文献综述。
结果证实了UC混合结构的有效性，主胸弯矫正良好（71 - 66%），且在2年随访时矫正丢失率低（3 - 4%）。青少年特发性脊柱侧凸（AIS）患者实现并维持的胸弯矫正似乎明显高于所有钩及钩混合技术所报告的矫正。无论全螺钉结构采用何种畸形矫正方法，实现的Cobb角矫正与UC混合装置所实现的矫正相当。在术前胸后凸值正常的现有的AIS患者中，最新随访时平均胸后凸几乎没有变化。然而，在术前T5 - T12后凸值较低的患者中，平均T5 - T12后凸有所改善。
UC混合结构安全，手术时间和失血量减少。在实现冠状面和矢状面畸形矫正方面，UC混合技术与所有螺钉或先前混合结构所报告的最佳结果相当，同时在矢状面似乎能提供更好的矫正。在2年随访时仍保持良好结果。
