Department of Spine Surgery, Eifelklinik St. Brigida, Simmerath, Germany.
IRCCS Istituto Ortopedico Galeazzi, Milano, Italy.
Eur Spine J. 2022 Apr;31(4):1060-1066. doi: 10.1007/s00586-021-07076-9. Epub 2021 Dec 15.
While the effects of VBT on coronal parameters have been investigated in various studies, this has not yet been the case for sagittal parameters. This is of particular relevance considering that VBT does not allow direct correction of the sagittal profile. Thus, we investigated the effects of VBT on sagittal parameters in patients with adolescent idiopathic scoliosis.
Retrospective, 2-Center study. Patients who underwent VBT and presented a 2-years follow-up were included. The differences in sagittal parameters were evaluated, along with modifications of sagittal profile following Abelin-Genevois' classification.
Data from 86 patients were obtained. Mean Cobb angle was 52.4 ± 13.9° at thoracic level and 47.6 ± 14.3° at lumbar level before surgery, and 28.5 ± 13.6 and 26.6 ± 12.7° at the 2-year follow-up, respectively. Mean thoracic kyphosis increased from 28.3 ± 13.8 to 33 ± 13°, the lumbar lordosis (LL) was unvaried (from 47.5 ± 13.1 to 48.4 ± 13.5°), PT decreased from 9.4 ± 8.5 to 7.4 ± 6.1°, the sagittal vertical axis SVA decreased from 4.5 ± 31.4 to - 3.6 ± 27.9 mm. No kyphotic effect on LL in patients who underwent lumbar instrumentation was observed. Before surgery, 39 patients had a type 1 sagittal profile, 18 were type 2a, 14 type 2b and 15 type 3. Postoperatively, 54 were type 1, 8 were 2a, 13 were 2b and 11 were type 3.
VBT positively influences sagittal parameters and does not have a kyphotic effect on LL.
虽然已经有多项研究调查了 VBT 对冠状参数的影响,但尚未研究其对矢状参数的影响。这一点尤为重要,因为 VBT 不允许直接矫正矢状位。因此,我们研究了 VBT 对青少年特发性脊柱侧凸患者矢状参数的影响。
回顾性、双中心研究。纳入接受 VBT 治疗并随访 2 年的患者。评估了矢状参数的差异,并按照 Abelin-Genevois 分类评估了矢状位曲线的变化。
共纳入 86 例患者的数据。术前胸椎 Cobb 角平均为 52.4°±13.9°,腰椎 Cobb 角平均为 47.6°±14.3°,术后 2 年随访时分别为 28.5°±13.6°和 26.6°±12.7°。平均胸椎后凸增加了 4.7°,从 28.3°±13.8°增加到 33°±13°,腰椎前凸(LL)没有变化(从 47.5°±13.1°增加到 48.4°±13.5°),骨盆倾斜(PT)从 9.4°±8.5°减少到 7.4°±6.1°,矢状垂直轴 SVA 从 4.5°±31.4mm 减少到-3.6°±27.9mm。在接受腰椎内固定的患者中,未观察到对 LL 的后凸效应。术前 39 例患者矢状位曲线为 1 型,18 例为 2a 型,14 例为 2b 型,15 例为 3 型。术后 54 例患者为 1 型,8 例为 2a 型,13 例为 2b 型,11 例为 3 型。
VBT 对矢状参数有积极影响,对 LL 没有后凸效应。