Daruwalla J S, Clark D W, Balasubramaniam P
Department of Orthopaedic Surgery, National University of Singapore.
Rev Chir Orthop Reparatrice Appar Mot. 1989;75(8):537-41.
The use of sublaminar segmental wires to enhance the stability of Harrington instrumentation was assessed in a review of our experience in the treatment of scoliosis over the last 6 years. Thirty patients were treated by spinal fusion, Harrington instrumentation and a prolonged postoperative period of immobilisation, initially in a plaster cast and then in a brace (Group 1). A further 29 patients have been treated by augmenting the Harrington instrumentation with sublaminar segmental wires (Group 2). Post-operatively, this group was left free of any brace or cast and early mobilisation was allowed. We observed no neurological complication in either group. The blood loss and the duration of the operation were greater in Group 2, but the period of hospitalisation and time to return to school has been markedly reduced. There has been no significant difference in the degree of correction of the scoliosis between the groups, but the improvement in kyphosis was greater with the use of sublaminar wires. There were no pseudoarthroses in either group during a minimum follow up of 18 months.
通过回顾我们过去6年治疗脊柱侧弯的经验,评估了使用椎板下节段性钢丝增强哈灵顿器械稳定性的效果。30例患者接受了脊柱融合术、哈灵顿器械固定以及术后长时间的制动,最初使用石膏固定,然后使用支具(第1组)。另外29例患者通过在哈灵顿器械上增加椎板下节段性钢丝进行治疗(第2组)。术后,该组患者无需使用任何支具或石膏,并允许早期活动。两组均未观察到神经并发症。第2组的失血量和手术时间更长,但住院时间和返校时间明显缩短。两组之间脊柱侧弯的矫正程度没有显著差异,但使用椎板下钢丝后后凸改善更大。在至少18个月的随访中,两组均未出现假关节。