Department of Orthopaedic Surgery, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1XB, Canada.
Department of Orthopaedic Surgery, Dana Children's Hospital, 6 Weizmann Street, 64239, Tel Aviv, Israel.
Spine Deform. 2021 Jul;9(4):969-976. doi: 10.1007/s43390-021-00300-y. Epub 2021 Feb 10.
The three-rod technique, utilising a short apical concavity rod is an option to achieve controlled correction in severe scoliosis. We describe this technique, the complications encountered, and the long-term outcomes.
All paediatric patients who had at least 2 years follow-up after undergoing corrective surgery for scoliosis ≥ 100° using 3 parallel rods were included. Radiographs were assessed to evaluate the correction and clinical records examined for any loss of correction, complications, revision procedures or neuromonitoring events.
Twenty-five patients met the inclusion criteria. Four underwent prior anterior fusion to prevent crankshaft phenomenon. The mean angle of the deformity was 112.0° (range 100.3-137.1). Mean maximal kyphosis was 48.8° (range 11.4-78.8°) and mean curve flexibility 4.4% (range 0-37.0%). Intraoperative traction achieved an average of 70.4% (95% CI 56.6-84.1%). Nine patients (39%) showed a reduction in MEPs during definitive surgery. All returned to within 75% of baseline by the end of surgery. All patients had normal postoperative neurology. One patient underwent removal of hardware for late infection. The mean overall Cobb correction was 55.7° (95% CI 50.2-61.2°), equating to 50.2% (95% CI 44.9-55.4%) of the mean initial deformity. Thoracic kyphosis reduced by a mean of 18.2° (95% CI 12.8-23.6°).
Our series suggests that three-rod constructs are able to safely and effectively achieve 50% correction of severe scoliosis.
三杆技术，利用短的顶端凹陷杆，是在严重脊柱侧凸中实现控制矫正的一种选择。我们描述了该技术、遇到的并发症以及长期结果。
所有接受过至少 2 年随访的儿科患者，在接受≥100°的脊柱侧凸矫正手术后，使用 3 根平行杆进行手术。评估 X 光片以评估矫正情况，并检查临床记录，以了解任何矫正丢失、并发症、修正程序或神经监测事件。
25 名患者符合纳入标准。4 名患者因曲轴现象风险行前路融合术。畸形的平均角度为 112.0°（范围 100.3-137.1°）。平均最大后凸角为 48.8°（范围 11.4-78.8°），平均曲线灵活性为 4.4%（范围 0-37.0%）。术中牵引平均达到 70.4%（95%可信区间 56.6-84.1%）。9 名患者（39%）在确定性手术中出现运动诱发电位下降。所有患者在手术结束时均恢复至基线的 75%以内。所有患者术后神经功能均正常。1 名患者因迟发性感染行内固定取出术。总体 Cobb 角矫正平均值为 55.7°（95%可信区间 50.2-61.2°），相当于平均初始畸形的 50.2%（95%可信区间 44.9-55.4%）。胸椎后凸减少了 18.2°（95%可信区间 12.8-23.6°）。
我们的系列研究表明，三杆结构能够安全有效地实现 50%的严重脊柱侧凸矫正。
