Yılar Sinan, Zeynal Mete, Toy Serdar, Köse Mehmet, Köse Ahmet
Ağrı Devlet Hastanesi Ortopedi ve Travmatoloji Kliniği, 04200 Ağrı, Türkiye.
Jt Dis Relat Surg. 2020;31(2):201-208. doi: 10.5606/ehc.2020.73017. Epub 2020 Apr 23.
This study aims to investigate if use of cannulated pedicle screw (CPS) in the dysplastic pedicles in Scheuermann's kyphosis (SK) increases the accuracy rate of the screw and reduces screw-related complications.
This retrospective study included 21 patients (11 males, 10 females; mean age 19.1 years; range, 13 to 22 years) (550 screws) who received correction with pedicle screws due to SK deformity between May 2015 and January 2019. Between 2017 and 2018, classical pedicle screws were used in addition to CPSs in the upper thoracic region (T2, T3, T4) and thin pedicles (group 1). However, during the years 2015 to 2016, only classical pedicle screws were used for the patients who underwent posterior instrumentation for SK (group 2). Computed tomography scanning was used to investigate the accuracy of the screws.
There were 12 patients (316 screws) in group 1 and nine patients (234 screws) in group 2. Seventy-four (13.4%) of all screws were inserted incorrectly. Incorrect screw rate in group 1 was significantly lower than group 2; 21 (6.6%) and 53 (22.6%), respectively (p<0.001). There were no complications related to the use of CPSs after a mean follow-up of two-and-a-half years.
The use of CPS in the surgical treatment of SK does not increase the complication rate; instead it increases the accuracy of the screw. For this reason, we believe that CPS may be an effective and reliable option in the treatment of SK.
本研究旨在探讨在休门氏病(SK)发育异常的椎弓根中使用空心椎弓根螺钉(CPS)是否能提高螺钉置入准确率并减少螺钉相关并发症。
本回顾性研究纳入了2015年5月至2019年1月期间因SK畸形接受椎弓根螺钉矫正的21例患者(男11例,女10例;平均年龄19.1岁;范围13至22岁)(共550枚螺钉)。2017年至2018年,在上胸部区域(T2、T3、T4)和椎弓根较细的部位,除使用CPS外还使用了传统椎弓根螺钉(第1组)。然而,在2015年至2016年期间,接受SK后路内固定的患者仅使用传统椎弓根螺钉(第2组)。采用计算机断层扫描来研究螺钉的置入准确率。
第1组有12例患者(316枚螺钉),第2组有9例患者(234枚螺钉)。所有螺钉中有74枚(13.4%)置入错误。第1组的螺钉置入错误率显著低于第2组,分别为21枚(6.6%)和53枚(22.6%)(p<0.001)。平均随访两年半后,未出现与使用CPS相关的并发症。
在SK的手术治疗中使用CPS不会增加并发症发生率;相反,它提高了螺钉的置入准确率。因此,我们认为CPS可能是治疗SK的一种有效且可靠的选择。