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哈林顿手术的长期结果。关于200例病例系列(1964 - 1986年)

[Long-term results of the Harrington operation. Apropos of a series of 200 cases (1964-1986)].

作者信息

Gaubert J, Clément J L, Bardier M, Gaubert J H, Thillaye du Boullay C, de Jong Z

出版信息

Ann Chir. 1989;43(3):195-202.

PMID:2712503
Abstract

The authors present a series of 200 patients who underwent vertebral arthrodesis with Harrington's distraction rods for idiopathic scoliosis reviewed after a mean follow-up of 7.5 years (maximum: 24 years). The surgical procedure consisted of either simple distraction or distraction associated with convex compression or a transverse traction device or insertion of double rods according to Armstrong's technique. The operative gain was 44%, the angular loss was 12% and the definitive gain was 32%. The results were better in girls and in juvenile scoliosis type III and adolescent scoliosis. The best long-term correction was obtained in cases of lumbar scoliosis. The best operative reduction was obtained in thoracic and thoracolumbar scoliosis and the greatest angular loss was observed with major double scolioses. The most favourable results were obtained in cases of scoliosis were severe angulation. The best system was Armstrong's followed by Dollar's and the least effective was simple distraction. Heavy pre- and intra-operative vertebral traction improved the angular score. Rupture of the rod, when it occurred late, was not equivalent to pseudarthrosis. Angular deterioration over time was essentially observed over the first 10 years but led to disappointing results.

摘要

作者报告了一组200例因特发性脊柱侧弯接受哈林顿撑开棒椎体融合术的患者,平均随访7.5年(最长24年)。手术方式包括单纯撑开,或撑开联合凸侧加压、横向牵引装置,或根据阿姆斯特朗技术插入双棒。手术矫正率为44%,角度丢失率为12%,最终矫正率为32%。女孩、青少年特发性脊柱侧弯III型和青少年脊柱侧弯患者的结果更好。腰椎侧弯患者获得了最佳的长期矫正效果。胸椎和胸腰段脊柱侧弯患者获得了最佳的手术复位效果,而主要的双主弯患者角度丢失最大。在严重成角的脊柱侧弯患者中获得了最有利的结果。最佳系统是阿姆斯特朗系统,其次是多拉尔系统,最无效的是单纯撑开。术前和术中的重度椎体牵引改善了角度评分。棒体断裂若发生在后期,不等同于假关节形成。角度随时间的恶化主要发生在最初10年,但结果令人失望。

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