Little J Paige, Izatt Maree T, Adam Clayton J, Lofgren Olivia, Sundberg Anna, Labrom Robert D, Askin Geoffrey N
Paediatric Spine Research Group, Institute of Health and Biomedical Innovation-Centre for Children's Health Research, Queensland University of Technology and Mater Health Services, 62 Graham Street, South Brisbane, Queensland 4101, Australia.
Paediatric Spine Research Group, Institute of Health and Biomedical Innovation-Centre for Children's Health Research, Queensland University of Technology and Mater Health Services, 62 Graham Street, South Brisbane, Queensland 4101, Australia.
Spine Deform. 2017 May;5(3):172-180. doi: 10.1016/j.jspd.2016.12.003.
In recent years, there has been increasing appreciation of the need to treat scoliosis as a three-dimensional deformity.
Assessment of surgical strategies and outcomes should consider not only the coronal plane correction but also derotation of the transverse plane deformity that can affect trunk appearance.
This study included a cohort of 29 female adolescent idiopathic scoliosis patients who received thoracoscopic single rod anterior fusion (TASF) surgery. This study used pre- and postoperative low-dose computed tomographic (CT) scans to accurately measure apical axial vertebral rotation (AVR).
The pre- and postoperative values for clinically measured coronal Cobb correction and rib hump correction as well as AVR were compared to determine whether these values improved postoperatively. There are no conflicts of interest to report for authors of this investigation.
As expected, statistically significant reductions in coronal Cobb angle (mean preoperative Cobb 51°, reducing to 24° at the two-year follow-up) and rib hump (mean preoperative rib hump 15°, reducing to 7° at two-year follow-up) were achieved. The mean reduction in apical AVR measured using CT was only 3° (mean preoperative AVR 16°, reducing to 13° at two-year follow-up), which was statistically but not clinically significant. Significant correlations were found between Cobb angle and rib hump, between Cobb angle and AVR, and between AVR and rib hump, suggesting that patients with greater coronal Cobb correction also achieve better derotation with this surgical procedure.
The historical low-dose CT data set permitted detailed three-dimensional assessment of the deformity correction that is achieved using thoracoscopic anterior spinal fusion for progressive adolescent idiopathic scoliosis.
近年来，人们越来越认识到将脊柱侧弯视为三维畸形进行治疗的必要性。
手术策略和结果的评估不仅应考虑冠状面矫正，还应考虑可影响躯干外观的横断面畸形的去旋转。
本研究纳入了29例接受胸腔镜下单棒前路融合术（TASF）的女性青少年特发性脊柱侧弯患者。本研究使用术前和术后低剂量计算机断层扫描（CT）来准确测量顶椎轴向旋转（AVR）。
比较术前和术后临床测量的冠状面Cobb角矫正、肋骨隆凸矫正以及AVR的值，以确定这些值术后是否有所改善。本研究的作者不存在利益冲突需要报告。
正如预期的那样，冠状面Cobb角（术前平均Cobb角51°，两年随访时降至24°）和肋骨隆凸（术前平均肋骨隆凸15°，两年随访时降至7°）在统计学上有显著降低。使用CT测量的顶椎AVR平均降低仅3°（术前平均AVR 16°，两年随访时降至13°），这在统计学上有意义，但在临床上无显著意义。在Cobb角与肋骨隆凸之间、Cobb角与AVR之间以及AVR与肋骨隆凸之间发现了显著相关性，这表明冠状面Cobb角矫正程度越大的患者，通过该手术也能实现更好的去旋转。
历史低剂量CT数据集允许对使用胸腔镜前路脊柱融合术治疗进展性青少年特发性脊柱侧弯所实现的畸形矫正进行详细的三维评估。
