Nagata H, Onomura T, Watanabe H
Department of Orthopedic Surgery Osaka Medical College, Japan.
Bull Osaka Med Coll. 1989 Nov;35(1-2):77-98.
We reviewed the results of posterior spinal fusion with Cotrel-Dubousset Instrumentation for idiopathic scoliosis from fifty-six patients (sixty-five curves). The postoperative follow-up on them ranged six months to three years and seven months with an average of one year and nine months. From overall results, scoliotic curves were corrected by 36.5 from 60.3 degrees before operation to 23.8 degrees after operation on average. The rate of correction was 60.5%. On a sagittal plane, thoracic kyphosis improved from 22 to 35 degrees in the Cobb angle of T1-T12, to be more physiologically aligned. In addition, the derotational effect was elucidated by the measurement on pre- and post-operative CAT scan images in the apical vertebra, and on moiré topography. A reduction of the rib hump and the trunk inclination was also noted, but did not necessarily reflect the correctional gain of the scoliotic curvature. From the biomechanical point of view, the correction of rotational deformity by CD instrumentation is derived from a couple of the following movements: one is rotation of the apical vertebra around its axis and the other is revolutional displacement of that vertebra on a transverse plane (R-R movement).
我们回顾了56例（65个弯曲）特发性脊柱侧凸患者采用Cotrel-Dubousset器械进行后路脊柱融合术的结果。对他们的术后随访时间为6个月至3年7个月，平均为1年9个月。从总体结果来看，脊柱侧凸弯曲平均从术前的60.3度矫正至术后的23.8度，矫正度数为36.5度，矫正率为60.5%。在矢状面上，T1-T12 Cobb角的胸椎后凸从22度改善至35度，更接近生理对齐。此外，通过术前和术后对顶椎的CAT扫描图像以及云纹图测量，阐明了去旋转效果。还注意到肋骨隆凸和躯干倾斜度有所减小，但这不一定反映脊柱侧凸弯曲的矫正程度。从生物力学角度来看，CD器械对旋转畸形的矫正源于以下几种运动：一种是顶椎绕其轴的旋转，另一种是该椎体在横断面上的旋转位移（R-R运动）。
