青少年特发性脊柱侧弯伴棒旋转的旋转评估
ROTATION ASSESSMENT IN ADOLESCENT IDIOPATHIC SCOLIOSIS WITH ROD DEROTATION.
作者信息
de Araujo Fernando Flores, Marcon Raphael Martus, Cristante Alexandre Fogaça, de Barros Tarcísio Eloy Pessoa, Letaif Olavo Biraghi
机构信息
Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas (IOT-HCFMUSP), Instituto de Ortopedia e Traumatologia, Spine Surgery Division, São Paulo, SP, Brazil.
出版信息
Acta Ortop Bras. 2019 Jan-Feb;27(1):42-45. doi: 10.1590/1413-785220192701191874.
OBJECTIVE
Adolescent idiopathic scoliosis (AIS) is characterized by rotational and lateral deformity of the spine. The measurement of vertebral rotation is important for prognosis and treatment. Our objective was to evaluate whether the Nash-Moe method can be used to measure axial deformity correction with surgical treatment using the rod derotation maneuver at both the apex and extremities of the deformity in patients with AIS.
METHODS
Rotation was assessed using the Nash and Moe criteria, on preoperative and postoperative radiographs. We also evaluated the severity on the coronal plane using the Cobb method, ratio of correction achieved, screw density, and number of vertebrae involved in the instrumentation.
RESULTS
The Cobb method correction average was 54.8%. When we disregarded vertebrae that presented preoperative Nash-Moe grade 0, the average measurable correction was 54.5% in the first non-instrumented vertebra above, 69.2% in the first instrumented vertebra, 32.2% in the apical vertebra, 36.8% in the last instrumented vertebra, and 30% in the first non-instrumented vertebra below. In our study, 32.14% of the patients presented a measurable correction in the apical vertebra.
CONCLUSION
On the axial plane, correction can be satisfactorily evaluated using the Nash-Moe method.
目的
青少年特发性脊柱侧凸（AIS）的特征是脊柱的旋转和侧方畸形。椎体旋转的测量对预后和治疗很重要。我们的目的是评估在AIS患者中，Nash-Moe方法是否可用于通过在畸形顶点和两端使用棒旋转操作的手术治疗来测量轴向畸形矫正。
方法
在术前和术后X线片上使用Nash和Moe标准评估旋转情况。我们还使用Cobb方法评估冠状面的严重程度、矫正达成率、螺钉密度以及器械固定所涉及的椎体数量。
结果
Cobb方法的平均矫正率为54.8%。当我们不考虑术前Nash-Moe分级为0的椎体时，上方第一个未进行器械固定的椎体的平均可测量矫正率为54.5%，第一个进行器械固定的椎体为69.2%，顶椎为32.2%，最后一个进行器械固定的椎体为36.8%，下方第一个未进行器械固定的椎体为30%。在我们的研究中，32.14%的患者顶椎有可测量的矫正。
结论
在轴面上，使用Nash-Moe方法可以令人满意地评估矫正情况。
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