Spine Surgery Division, 1, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi, 4, 20161, Milan, Italy.
Sci Rep. 2021 Jan 8;11(1):19. doi: 10.1038/s41598-020-79523-4.
Aim of the study was to evaluate sagittal parameters modifications, with particular interest in thoracic kyphosis, in patients affected by adolescent idiopathic scoliosis (AIS) comparing hybrid and all-screws technique. From June 2010 to September 2018, 145 patients were enrolled. Evaluation included: Lenke classification, Risser scale, coronal Cobb angle, thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS). Patients were divided in two groups (1 all-screws and 2 hybrid); a further division, in both groups, was done considering preoperative TK values. Descriptive and inferential statistical analysis was conducted. 99 patients were in group 1, 46 in group 2 (mean follow-up 3.7 years). Patients with a normo-kyphotic profile developed a little variation in TK (Δ pre-post = 2.4° versus - 2.0° respectively). Hyper-kyphotic subgroups had a tendency of restoring a good sagittal alignment. Hypo-kyphotic subgroups, patients treated with all-screw implants developed a higher increase in TK mean Cobb angle (Δ pre-post = 10°) than the hybrid subgroup (Δ pre-post = 5.4°) (p = 0.01). All-screws group showed better results in restoring sagittal alignment in all subgroups compared to hybrid groups, especially in hypo-TK subgroup, with the important advantage to give better correction on coronal plane.
研究目的是评估矢状参数的变化，特别关注青少年特发性脊柱侧凸（AIS）患者的胸椎后凸（TK），比较了杂交技术和全螺钉技术。2010 年 6 月至 2018 年 9 月，共纳入 145 例患者。评估包括：Lenke 分类、Risser 分级、冠状 Cobb 角、胸椎后凸角（TK）、腰椎前凸角（LL）、矢状垂直轴（SVA）、骨盆入射角（PI）、骨盆倾斜角（PT）、骶骨倾斜角（SS）。患者分为两组（1 组为全螺钉，2 组为杂交）；在两组中，进一步根据术前 TK 值进行分组。进行描述性和推断性统计分析。1 组 99 例，2 组 46 例（平均随访 3.7 年）。正常后凸组 TK 变化较小（术前-术后分别为 2.4°和-2.0°）。胸椎后凸过度组有恢复良好矢状排列的趋势。胸椎后凸不足组，全螺钉组患者的 TK 平均 Cobb 角增加（术前-术后分别为 10°和 5.4°）高于杂交组（p=0.01）。与杂交组相比，全螺钉组在所有亚组中均能更好地恢复矢状排列，尤其是在胸椎后凸不足亚组中，具有在冠状面更好地矫正的重要优势。
