Feng Jing, Zhou Juan, Huang Mi, Xia Ping, Liu Wei
Department of Orthopaedics, First Hospital of Wuhan, No. 215 Zhongshan Road, Wuhan, 430022, China.
J Orthop Surg Res. 2018 Nov 29;13(1):305. doi: 10.1186/s13018-018-1001-0.
To compare the clinical and radiological outcomes of the surgical correction of Lenke type 1 to 4 scoliosis by using a multilevel Ponte osteotomy procedure with posterior selective segmental pedicle screw constructs or posterior release and selective segmental pedicle screw constructs only in patients with adolescent thoracic idiopathic scoliosis.
Retrospective analysis of 65 patients, 32 treated with the multilevel Ponte procedure (Group A) and 33 with posterior soft tissue release only (Group B). The groups were compared with regard to the change in spinal alignment from preoperative to postoperative assessment and over the follow-up period.
A correction rate of the main thoracic curve of 63.9 ± 4.5% was obtained for group A and 65.2 ± 2.4% for group B (P = 0.17). However, the Cincinnati correction index was greater for group A (1.8 ± 0.3) than that for group B (1.4 ± 0.2, P < 0.001), with a smaller change in angle over the period from 1 week postoperatively to the 2-year follow-up (P < 0.05). The operative time, volume of blood loss, and volume of transfusion were greater for group A than for group B (P < 0.05).
The multilevel Ponte osteotomy procedure, with posterior selective segmental pedicle screw constructs, improves the Cincinnati correction index and restores the thoracic kyphosis in patients with adolescent thoracic idiopathic scoliosis.
在青少年特发性胸椎侧弯患者中，比较采用多级 Ponte 截骨术联合后路选择性节段椎弓根螺钉内固定与单纯后路松解加选择性节段椎弓根螺钉内固定对 Lenke 1 至 4 型脊柱侧弯进行手术矫正的临床和影像学结果。
对 65 例患者进行回顾性分析，其中 32 例采用多级 Ponte 手术治疗（A 组），33 例仅采用后路软组织松解治疗（B 组）。比较两组术前至术后评估以及随访期间脊柱排列的变化。
A 组主胸弯矫正率为 63.9±4.5%，B 组为 65.2±2.4%（P = 0.17）。然而，A 组的辛辛那提矫正指数（1.8±0.3）高于 B 组（1.4±0.2，P < 0.001），术后 1 周至 2 年随访期间角度变化较小（P < 0.05）。A 组的手术时间、失血量和输血量均多于 B 组（P < 0.05）。
采用后路选择性节段椎弓根螺钉内固定的多级 Ponte 截骨术可提高青少年特发性胸椎侧弯患者的辛辛那提矫正指数并恢复胸椎后凸。
