Shi B L, Liu D, Xia S Q, Li Y, Shi B, Liu Z, Sun X, Zhu Z Z, Qiu Y
Department of Spine Surgery, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210008, China.
Zhonghua Yi Xue Za Zhi. 2019 Dec 17;99(47):3710-3714. doi: 10.3760/cma.j.issn.0376-2491.2019.47.007.
To evaluate the radiographic and clinical outcomes of sequential correction based on satellite rod technique in degenerative scoliosis (DS) with B-type coronal imbalance, and to investigate the efficacy of sequential correction in this cohort. Twenty-one DS patients with B-type coronal imbalance applying sequential correction from December 2015 to July 2017 in Nanjing Drum Tower Hospital were retrospectively reviewed. There were 4 males and 17 females in this group, the average age was (63±8) years. The coronal parameters including Cobb angle of main curve and distance between C(7) plumb line and center sacral vertical line (C(7)PL-CSVL), as well as sagittal parameters including global kyphosis (GK) and sagittal vertical axis (SVA) were assessed pre-operatively, post-operatively and at the last follow-up. The Scoliosis Research Society-22 (SRS-22) questionnaire was fulfilled before the operation and at each follow-up to evaluate the quality of life. Paired test was performed for statistical analysis. The patients were followed-up for (20±8) months. The post-operative Cobb angle of main curve was significantly improved from 52°±12° to 19°±7° (13.886, 0.01), and it was 19°±8° at the last follow-up and no significant correction loss was attained (1.101, 0.284). The values of C(7)PL-CSVL before the operation, after the operation and at the final follow-up were (46±11) mm, (12±7) mm and (12±7) mm, respectively; significant post-operative improvement achieved (19.718, 0.01) while there was no correction loss at last follow-up (-1.393, 0.179). After sequential correction, 20 patients (95.2%) improved to A-type coronal imbalance while 1 patient (4.8%) remained with B-type coronal imbalance. Significant post-operative improvements were found in terms of GK and SVA and no significant correction loss was found during follow-up. The scores of pain and self-image showed significant improvement at the last follow-up (8.706, 3.104, both 0.01). In addition, there was no implant failure during follow-up. The sequential correction based on satellite rod technique in DS patients with B-type coronal imbalance corrects the deformity, relieves the clinical symptoms, improves the quality of life, and decreases the rates of post-operative coronal imbalance as well as implant-related complications.
评估基于卫星棒技术的序贯矫正治疗B型冠状面失平衡的退变性脊柱侧凸(DS)的影像学和临床疗效,并探讨该队列中序贯矫正的有效性。回顾性分析2015年12月至2017年7月在南京鼓楼医院应用序贯矫正治疗的21例B型冠状面失平衡的DS患者。该组有4例男性和17例女性,平均年龄为(63±8)岁。术前、术后及末次随访时评估冠状面参数,包括主弯Cobb角和C7铅垂线与骶骨中心垂直线(C7PL-CSVL)之间的距离,以及矢状面参数,包括整体后凸(GK)和矢状垂直轴(SVA)。术前及每次随访时完成脊柱侧凸研究学会-22(SRS-22)问卷以评估生活质量。采用配对t检验进行统计分析。患者随访(20±8)个月。术后主弯Cobb角从52°±12°显著改善至19°±7°(t=13.886,P=0.01),末次随访时为19°±8°,无明显矫正丢失(t=1.101,P=0.284)。术前、术后及末次随访时C7PL-CSVL值分别为(46±11)mm、(12±7)mm和(12±7)mm;术后有显著改善(t=19.718,P=0.01),末次随访时无矫正丢失(t=-1.393,P=0.179)。序贯矫正后,20例患者(95.2%)改善为A型冠状面失平衡,1例患者(4.8%)仍为B型冠状面失平衡。术后GK和SVA有显著改善,随访期间无明显矫正丢失。末次随访时疼痛和自我形象评分有显著改善(t分别为8.706、3.104,P均为0.01)。此外,随访期间无内植物失败。基于卫星棒技术的序贯矫正治疗B型冠状面失平衡的DS患者可矫正畸形、缓解临床症状、改善生活质量,并降低术后冠状面失平衡率以及内植物相关并发症的发生率。