Branche Katherine, Netsanet Rahwa, Noshchenko Andriy, Burger Evalina, Patel Vikas, Ou-Yang David, Kleck Christopher J
Department of Orthopedics, University of Colorado, Anschutz Medical Campus, Aurora, Colorado.
Int J Spine Surg. 2020 Dec;14(6):944-948. doi: 10.14444/7143. Epub 2020 Dec 29.
Recent studies support the need for sagittal alignment restoration when performing lumbar degenerative spinal fusions. The development of patient-specific spine rods (PSSRs) may help maintain or improve sagittal alignment in these surgeries.
A retrospective review was conducted for patients who underwent posterior spinal surgeries involving 4 or less levels. The preplanned PSSR radii of curvature (ROC) was compared with standard prebent rods with a ROC of 125 mm. All surgeries were performed at a single institution by 3 surgeons from September 2016 through October 2018. Data were then compared using a 2-tailed paired test. PSSR had either 1 or 2 definitive ROCs.
For rods with 2 ROCs, the "cranial" curve was measured between the upper instrumented level and L4 or L5. The "caudal" curve was measured between L4 or L5 and the lower instrumented level. The PSSR with 1 ROC and the caudal portion of the rods with 2 ROCs were significantly smaller than the industry standard ROC.
PSSR demonstrate more acute ROC than industry standard rods. In PSRs, the most lordosis occurs between L4-S1 and flattens out at the thoracolumbar junction, mimicking the normal distribution of lumbar lordosis. PSSRs could help achieve or maintain sagittal alignment and prevent the sequela of flat back syndrome.
近期研究支持在进行腰椎退行性脊柱融合手术时恢复矢状位对线的必要性。定制脊柱棒（PSSRs）的发展可能有助于在这些手术中维持或改善矢状位对线。
对接受4个及以下节段后路脊柱手术的患者进行回顾性研究。将预先计划的PSSR曲率半径（ROC）与曲率半径为125mm的标准预弯棒进行比较。所有手术均由3位外科医生于2016年9月至2018年10月在单一机构进行。然后使用双尾配对检验比较数据。PSSR有1个或2个确定的ROC。
对于有2个ROC的棒，“头侧”曲线在上端固定节段与L4或L5之间测量。“尾侧 ”曲线在L4或L5与下端固定节段之间测量。具有1个ROC的PSSR和具有2个ROC的棒的尾侧部分明显小于行业标准ROC。
PSSR显示出比行业标准棒更锐利的ROC。在PSRs中，最大前凸出现在L4-S1之间，并在胸腰段交界处变平，模仿腰椎前凸的正常分布。PSSRs有助于实现或维持矢状位对线，并预防平背综合征的后遗症。
