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经直接凸侧棒手法矫正青少年特发性胸椎侧凸。

Correction of thoracic adolescent idiopathic scoliosis via a direct convex rod manoeuvre.

机构信息

Service de Chirurgie Pédiatrique, Hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, 35200 Rennes, France.

Service de Chirurgie Pédiatrique, Hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, 35200 Rennes, France.

出版信息

Orthop Traumatol Surg Res. 2019 Oct;105(6):1171-1174. doi: 10.1016/j.otsr.2019.05.007. Epub 2019 Jun 19.

Abstract

The various techniques available for scoliosis surgery via the posterior approach involve positioning implants on either side of the curve and reducing the deformity by manoeuvres on the concave rod or simultaneously on both rods. Correction solely via a direct convex rod manoeuvre would eliminate the need for implants on the concave side. This technique was used to treat thoracic adolescent idiopathic scoliosis in 23 patients with a mean age of 14 years and 9 months. Low-dose biplanar EOS radiographs were obtained before surgery, on post-operative day 7, and at last follow-up (at least 2 years after surgery) to allow comparisons of Cobb's angle (72°, 33°, and 35°, respectively), thoracic kyphosis (21°, 29°, and 26°), lumbar lordosis (58°, 50°, and 55°), and apical vertebra rotation (-26°,-12°, and-11°). Although scoliosis requires corrections in all three dimensions, this technique seems to produce satisfactory outcomes while obviating the need for implants on the concave side, thereby decreasing the risk of iatrogenic adverse events. LEVEL OF EVIDENCE: IV.

摘要

后路脊柱侧凸手术的各种技术包括在曲线的两侧定位植入物,并通过凹侧棒的操作或同时对两根棒进行操作来减小畸形。仅通过直接凸侧棒操作进行矫正将消除在凹侧使用植入物的需要。该技术用于治疗 23 例平均年龄为 14 岁 9 个月的青少年特发性脊柱侧凸。在术前、术后第 7 天和末次随访(术后至少 2 年)时获得低剂量双平面 EOS 射线照片,以比较 Cobb 角(分别为 72°、33°和 35°)、胸椎后凸(21°、29°和 26°)、腰椎前凸(58°、50°和 55°)和顶椎旋转(-26°、-12°和-11°)。虽然脊柱侧凸需要在三个维度上进行矫正,但这种技术似乎可以产生令人满意的结果,同时避免在凹侧使用植入物,从而降低医源性不良事件的风险。证据水平:IV。

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