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植入物密度不改变主曲线和伴随曲线的矫正率:连续与间断椎弓根螺钉结构的比较。

The implant density does not change the correction rate of the main and the accompanying curves: A comparison between consecutive and intermittent pedicle screw constructs.

作者信息

Şenköylü Alpaslan, Çetinkaya Mehmet, Daldal İsmail, Eren Ali, Aktaş Erdem

机构信息

Department of Orthopaedics and Traumatology, Gazi University, School of Medicine, Ankara, Turkey.

Department of Orthopaedics and Traumatology, Erzincan Binali Yıldırım University, Mengücek Gazi Training and Research Hospital, Erzincan, Turkey.

出版信息

Acta Orthop Traumatol Turc. 2020 May;54(3):293-299. doi: 10.5152/j.aott.2020.03.16.

Abstract

OBJECTIVE

The aim of this study was to evaluate the clinical outcomes and the coronal correction rate of the main and accompanying curves of adolescent idiopathic scoliosis (AIS) corrected with pedicle screws inserted consecutively or intermittently.

METHODS

The prospectively collected data of 60 patients (8 men and 52 women; mean age: 14.6±2.5 years) who underwent corrective surgery for AIS between January 2010 and December 2015 were reviewed retrospectively. Two groups were constituted according to the pedicle screw construct type: consecutive pedicle screw construct (CPSC) and intermittent pedicle screw construct (IPSC) groups. The preoperative, early postoperative, and 24-month follow-up radiographs and the Scoliosis Research Society-22 (SRS-22) scores were reevaluated. The Cobb angle of the main and accompanying curves, the correction rate, and the flexibility of the curves were calculated.

RESULTS

The mean preoperative Cobb angles were 57.03° and 57.46°, the mean postoperative Cobb angles were 14.93° and 14.4°, and the mean correction rates were 76.22% and 75.31% in IPSC and CPSC groups, respectively (p>0.05). The preoperative and postoperative accompanying curve magnitudes and correction rates were similar (p>0.05). These radiographic outcomes were also consistent with the SRS-22 scores.

CONCLUSION

Both the pedicle screw constructs had satisfactory outcomes following the surgery, which were confirmed by both the SRS-22 scores and radiographs taken perioperatively and at follow-ups. The IPSC and CPSC groups did not demonstrate a significant change in the correction rate of the main and minor or major accompanying structural and nonstructural curves, and also in the SRS-22 scores.

LEVEL OF EVIDENCE

Level III, Retrospective comparative study.

摘要

目的

本研究旨在评估采用连续或间断置入椎弓根螺钉矫正青少年特发性脊柱侧凸(AIS)主弯和伴随弯的临床疗效及冠状面矫正率。

方法

回顾性分析2010年1月至2015年12月期间接受AIS矫正手术的60例患者(8例男性,52例女性;平均年龄:14.6±2.5岁)的前瞻性收集数据。根据椎弓根螺钉固定方式分为两组:连续椎弓根螺钉固定(CPSC)组和间断椎弓根螺钉固定(IPSC)组。重新评估术前、术后早期及24个月随访时的X线片以及脊柱侧凸研究学会22项(SRS-22)评分。计算主弯和伴随弯的Cobb角、矫正率及弯曲柔韧性。

结果

IPSC组和CPSC组术前平均Cobb角分别为57.03°和57.46°,术后平均Cobb角分别为14.93°和14.4°,平均矫正率分别为76.22%和75.31%(p>0.05)。术前和术后伴随弯的大小及矫正率相似(p>0.05)。这些影像学结果也与SRS-22评分一致。

结论

两种椎弓根螺钉固定方式术后均取得了满意的疗效,这在SRS-22评分以及围手术期和随访时拍摄的X线片中均得到证实。IPSC组和CPSC组在主弯和次要或主要伴随结构性及非结构性弯的矫正率以及SRS-22评分方面均未显示出显著变化。

证据水平

III级,回顾性比较研究。

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