Xu Ximing, Wang Fei, Zhou Xiaoyi, Cheng Yajun, Wei Xianzhao, Bai Yushu, Li Ming
From the Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China.
Medicine (Baltimore). 2015 Oct;94(41):e1616. doi: 10.1097/MD.0000000000001616.
The primary aim was to compare postoperative radiographic outcomes between sexes among adolescent idiopathic scoliosis (AIS) patients. A total of 162 AIS patients (42 males and 120 females) undergoing pedicle screw instrumentation and posterior fusion were included. Coronal and sagittal curves and flexibilities were measured and calculated. The postoperative correction rate (CR), fulcrum bending correction index (FBCI), and Cincinnati correction index were evaluated to compare the surgical benefits between sexes.Males were older (16.79 vs 14.79 years, respectively; P < 0.01) and had stiffer curves than females (lateral bending flexibility percentage: 47.77 vs 52.57, respectively, P = 0.21; traction flexibility percentage: 35.48 vs 36.98, respectively, P = 0.98; fulcrum bending flexibility percentage: 56.13 vs 66.57, respectively, P < 0.05). Males and females exhibited similar Lenke classification schemes (P = 0.72), but had different Risser signs (P < 0.01). Although males had greater postoperative curves (20.81° vs 16.83°, respectively; P = 0.009), no obvious differences in the CRs were noted between males and females (FBCI: 145.20% vs 108.37%, respectively; P = 0.92). Smaller preoperative lumbar lordosis was noted in males than in females (40.05° vs 45.72°, respectively; P = 0.03), yet no statistically significant differences in the preoperative and postoperative sagittal curves were observed between the sexes. In conclusion, considering the preoperative flexibilities, the 2 sexes achieved comparable surgical benefits without sacrificing the sagittal balance.
主要目的是比较青少年特发性脊柱侧凸（AIS）患者中不同性别的术后影像学结果。纳入了162例行椎弓根螺钉内固定和后路融合术的AIS患者（42例男性和120例女性）。测量并计算了冠状面和矢状面曲线及柔韧性。评估术后矫正率（CR）、支点弯曲矫正指数（FBCI）和辛辛那提矫正指数，以比较不同性别之间的手术获益情况。男性年龄更大（分别为16.79岁和14.79岁；P<0.01），且曲线比女性更僵硬（侧弯柔韧性百分比：分别为47.77和52.57，P=0.21；牵引柔韧性百分比：分别为35.48和36.98，P=0.98；支点弯曲柔韧性百分比：分别为56.13和66.57，P<0.05）。男性和女性表现出相似的Lenke分类方案（P=0.72），但Risser征不同（P<0.01）。尽管男性术后曲线更大（分别为20.81°和16.83°；P=0.009），但男性和女性之间的CRs没有明显差异（FBCI：分别为145.20%和108.37%；P=0.92）。男性术前腰椎前凸小于女性（分别为40.05°和45.72°；P=0.03），但两性术前和术后矢状面曲线没有统计学上的显著差异。总之，考虑到术前柔韧性，两性在不牺牲矢状面平衡的情况下获得了相当的手术获益。
