Li Yang, Shi Benlong, Liu Dun, Liu Zhen, Sun Xu, Qiu Yong, Zhu Zezhang
J Neurosurg Spine. 2021 Apr 2;34(6):857-863. doi: 10.3171/2020.9.SPINE201168. Print 2021 Jun 1.
The aim of this paper was to compare the radiographic and clinical outcomes between the sequential correction (SC) technique and the traditional 2-rod correction (TC) technique in patients with severe thoracic idiopathic scoliosis (STIS) undergoing posterior-only correction surgery.
Records of a consecutive series of STIS patients undergoing posterior-only correction surgery between October 2013 and October 2017 with more than 2 years of follow-up were reviewed. The radiographic parameters were assessed preoperatively, postoperatively, and at the last follow-up. Radiographic parameters, operative time, blood loss, and complications were compared between the two groups.
A total of 33 patients were included in the SC group, and 21 patients were included in the TC group. There was no significant difference in age, sex, or deformity magnitude (93.6° ± 7.8° vs 89.8° ± 6.6°, p = 0.070) preoperatively between groups. The operation time was shorter in the SC group than in the TC group (251.5 ± 42.8 minutes vs 275.4 ± 39.8 minutes, p = 0.020), while both blood loss (1284.6 ± 483.3 vs 1398.0 ± 558.4 ml, p = 0.432) and number of fused levels (13.1 ± 2.8 vs 13.6 ± 2.4, p = 0.503) were similar between the groups. Compared with the TC group, patients in the SC group had a higher correction rate (55.8% ± 9.2% vs 45.7% ± 8.8%, p < 0.001), less coronal (1.1° ± 0.81° vs 2.9° ± 0.93°, p < 0.001) and sagittal (1.5° ± 0.96° vs 2.1° ± 0.64°, p = 0.015) correction loss at the 2-year follow-up, and a lower incidence of intraoperative pedicle screw pullout (14.3% vs 23.8%, p = 0.026).
The SC technique could significantly and practically reduce the difficulty of rod installation with better deformity correction outcomes than the traditional TC technique. The SC technique was an effective alternative for patients with STIS.
本文旨在比较序贯矫正（SC）技术与传统双棒矫正（TC）技术在仅接受后路矫正手术的重度特发性胸椎侧弯（STIS）患者中的影像学和临床疗效。
回顾了2013年10月至2017年10月期间连续一系列仅接受后路矫正手术且随访超过2年的STIS患者的记录。在术前、术后及最后一次随访时评估影像学参数。比较两组之间的影像学参数、手术时间、失血量及并发症情况。
SC组共纳入33例患者，TC组共纳入21例患者。两组术前年龄、性别或畸形程度无显著差异（93.6°±7.8° vs 89.8°±6.6°，p = 0.070）。SC组手术时间短于TC组（251.5±42.8分钟 vs 275.4±39.8分钟，p = 0.020），而两组失血量（1284.6±483.3 vs 1398.0±558.4 ml，p = 0.432）及融合节段数（13.1±2.8 vs 13.6±2.4，p = 0.503）相似。与TC组相比，SC组患者矫正率更高（55.8%±9.2% vs 45.7%±8.8%，p < 0.001），在2年随访时冠状面（1.1°±0.81° vs 2.9°±0.93°，p < 0.001）和矢状面（1.5°±0.96° vs 2.1°±0.64°，p = 0.015）矫正丢失更少，术中椎弓根螺钉拔出发生率更低（14.3% vs 23.8%，p = 0.026）。
与传统TC技术相比，SC技术可显著且切实降低棒植入难度，畸形矫正效果更好。SC技术是STIS患者的一种有效替代方法。
