Kilinc Bekir Eray, Tran Dong Phuong, Johnston Charles
Texas Scottish Rite Hospital for Children, Dallas, TX, USA.
Acta Ortop Bras. 2019 Jan-Feb;27(1):33-37. doi: 10.1590/1413-785220192701189400.
To compare radiographic and surgical outcomes of Lenke 1B and 1C patterns.
One hundred twenty patients with Lenke 1B and 1C scoliosis were grouped according to implant density as follows: low density (LD) of ≤1.4 and high density (HD) of >1.4. Matched subgroups (30 patients each) based on age, curve magnitude, and body mass index (BMI) were analyzed. Radiographic parameters were evaluated before operation, immediately after operation (ipo), and at 2 years' follow-up. SRS-30 was administered before operation and at 2 years' follow-up.
The major curves of the LD (n = 82) and HD groups (n=38) were respectively 59.1° and 65.6° before operation (p <.001), 26.3° and 22.9° ipo (p =.05), and 29.9° and 19.8° at 2 years' follow-up (p <.001). No significant differences in postoperative trunk shift and coronal balance were found (p =.69 and p =.74, respectively). The HD group had higher blood loss (p =.02), number of implants (p <.001), levels fused (p =.002), and surgical time (p <.001). The HD group had a higher prevalence of hypokyphosis from before operation to follow-up (p <.001). No significant differences were observed in the SRS-30 scores before operation and at 2 years' follow-up. The matched groups had similar preoperative major curves (p =.56), ages (p =.75), and BMIs (p =.61). Significantly longer surgical time (p =.009), higher density (p <.001), and better correction (p =.0001) were found in the HD group at 2 years' follow-up. No significant differences were found in the SRS-30 scores before operation and at 2 years' follow-up.
LD constructs included fewer segments fused, lower intraoperative estimated surgical blood loss, and shorter operation time, and potentially decreasing complication risks due to fewer implants.
比较Lenke 1B型和1C型脊柱侧弯的影像学及手术疗效。
120例Lenke 1B型和1C型脊柱侧弯患者按植入物密度分组如下：低密度（LD）组≤1.4，高密度（HD）组>1.4。分析基于年龄、侧弯度数和体重指数（BMI）匹配的亚组（每组30例患者）。在术前、术后即刻（ipo）及2年随访时评估影像学参数。在术前及2年随访时进行SRS-30评分。
LD组（n = 82）和HD组（n = 38）术前主弯分别为59.1°和65.6°（p <.001），术后即刻分别为26.3°和22.9°（p =.05），2年随访时分别为29.9°和19.8°（p <.001）。术后躯干偏移和冠状面平衡无显著差异（分别为p =.69和p =.74）。HD组失血更多（p =.02）、植入物数量更多（p <.001）、融合节段更多（p =.002）、手术时间更长（p <.001）。HD组从术前到随访时后凸不足的发生率更高（p <.001）。术前及2年随访时SRS-30评分无显著差异。匹配组术前主弯（p =.56）、年龄（p =.75）和BMI（p =.61）相似。在2年随访时，HD组手术时间显著更长（p =.009）、密度更高（p <.001）、矫正效果更好（p =.0001）。术前及2年随访时SRS-30评分无显著差异。
LD固定融合节段更少、术中估计失血量更低、手术时间更短，且因植入物更少可能降低并发症风险。
