Vokes Jordan, Menga Emmanuel, Mesfin Addisu
Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, USA.
Orthopaedics Spine Surgery, University of Rochester, Rochester, USA.
Cureus. 2021 Apr 5;13(4):e14299. doi: 10.7759/cureus.14299.
Limited unilateral instrumentation has been used in the past in the treatment of adolescent idiopathic scoliosis; however, to our knowledge, there are no reported cases with ultra-long follow up regarding this. Our objective is to report on the 43-year follow-up of limited Harrington rod instrumentation for the treatment of a double major adolescent idiopathic scoliosis curve. We describe the patient's initial presentation, including history, physical exam, radiographic findings and clinical decision-making. Initial coronal cobb angle measurements before surgery were: 14° T1-T5, 42° T5-T12, 44° T12-L4. At 43 years of follow up, there was progression (14°>24°, 42°>70°, 44°>50°) of the patient's double major scoliosis curve despite unilateral, limited Harrington rod instrumentation from L4-S1. The patient was treated with a T3-pelvis instrumentation and fusion and posterior column osteotomies. To our knowledge, this is the longest follow-up and subsequent revision of a patient undergoing limited, unilateral Harrington rod instrumented fusion for the treatment of a double major adolescent idiopathic scoliosis curve.
过去曾采用有限的单侧器械治疗青少年特发性脊柱侧凸;然而,据我们所知,尚无关于此治疗方法的超长随访报告病例。我们的目的是报告对一名双主弯青少年特发性脊柱侧凸患者采用有限的哈灵顿棒器械治疗后的43年随访情况。我们描述了患者的初始表现,包括病史、体格检查、影像学检查结果及临床决策。手术前初始冠状面 Cobb 角测量值为:T1 - T5 为14°,T5 - T12 为42°,T12 - L4 为44°。在43年的随访中,尽管对该患者从L4 - S1进行了单侧有限的哈灵顿棒器械治疗,但双主弯脊柱侧凸仍有进展(14°>24°,42°>70°,44°>50°)。该患者接受了T3 - 骨盆器械固定融合及后路截骨术。据我们所知,这是对一名接受有限单侧哈灵顿棒器械固定融合治疗双主弯青少年特发性脊柱侧凸患者的最长随访及后续翻修情况。