O'Neill J A, Engler G L
New York University Medical Center, New York 10016.
J Spinal Disord. 1988;1(3):211-8.
A modification of the technique of Harrington instrumentation for idiopathic scoliosis utilizes segmental spinous process wiring. The purpose of this study is to contrast and compare two populations of surgically treated patients with idiopathic scoliosis: one group with a single Harrington distraction rod and the other group with the addition of spinous process wiring. Of 252 consecutive patients between 1971 and 1987, 215 were retrievable, with an average clinical follow-up of 2.2 years. Curves were analyzed by location and patient age. Patients treated with spinous process wires were braced, those without were casted. No significant difference in terms of percent correction with time was evident between the two treatment groups. The complication rate (11.0%) and pseudarthrosis rate (4.0%) were the same in both wired and standard groups. The more rigid adult curves resulted in less correction and greater complications than adolescent curves. Spinous process wiring seemed to protect against upper hook cut-out. There were no deaths or paraplegias. Patients surgically treated with the wire modification enjoyed greater comfort with the removable brace, and curve correction was equal to that obtained in patients treated with the standard technique and post-op casting.
一种针对特发性脊柱侧凸的哈林顿器械技术改良采用了节段性棘突钢丝固定术。本研究的目的是对比和比较两组接受手术治疗的特发性脊柱侧凸患者：一组使用单根哈林顿撑开棒，另一组在此基础上增加棘突钢丝固定术。在1971年至1987年间连续收治的252例患者中，可追踪到215例，平均临床随访时间为2.2年。根据曲线位置和患者年龄对曲线进行分析。接受棘突钢丝固定术治疗的患者使用支具，未接受该治疗的患者使用石膏固定。两个治疗组在随时间的矫正百分比方面没有明显差异。钢丝固定组和标准组的并发症发生率（11.0%）和假关节发生率（4.0%）相同。与青少年曲线相比，成人更僵硬的曲线矫正效果较差且并发症更多。棘突钢丝固定术似乎能防止上钩脱出。没有死亡或截瘫病例。接受钢丝改良手术治疗的患者使用可摘除支具时舒适度更高，且曲线矫正效果与接受标准技术和术后石膏固定治疗的患者相当。
