Balsano Massimo, Vacchiano Andrea, Bagnis Francesco, Segalla Sara, Spina Mauro
Regional Spinal Department, University and Hospital Trust, Verona, Italy.
Orthopaedics and Traumatology, Carlo Poma Hospital, Mantua, Italy.
Int Orthop. 2022 Aug;46(8):1847-1853. doi: 10.1007/s00264-022-05439-5. Epub 2022 May 17.
The Rod Link Reducer (RLR) (Globus Medical, PA, USA) allows direct three-dimensional correction of the spine deformity follows the direct vertebral rotation (DVR) theories. The purpose of this retrospective study is to compare RLR with traditional correction technique (TCT) in two cohorts of patients with adolescent idiopathic scoliosis (AIS).
Fifty-four patients (M:F = 1:8) between 2018 and 2020 were included. The first group (n = 22) was treated by RLR while the second one (n = 32) by TCT. All spines were classified as per the Lenke system. Length of hospitalization, days in intensive care unit (ICU), operative time, and blood loss were recorded. SRS-30 and SF-36 questionnaires were administered pre-operative and post-operative. We collected radiological data: pre-operative and post-operative Cobb angles, coronal and sagittal balance, trunk and thoracic height.
RLR and TCT groups are homogeneous in age (p = 0.317), sex ratio (p = 0.347), and Risser stage (p = 0.222). Between both groups there was no significant statistical difference in haemoglobin value, hospitalization length, days in ICU, operative times, SF-36, SRS-30, NRS, and perceived satisfaction. RLR group shows a better improvement of correction of main thoracic (MT) curve (RLR 54.2% ± 15.9%/TCT 38.1% ± 20.4%, p = 0.031). Nevertheless, RLR group shows a worse thoracic kyphosis correction (RLR 16.82° ± 9.13°/27.12° ± 12.13°, p = 0.015).
RLR system allows a more effective MT curve correction than TCT systems, but it seems to give a hypokyphosis effect.
杆连杆式矫形器(RLR)(美国宾夕法尼亚州的Globus Medical公司生产)可根据直接椎体旋转(DVR)理论对脊柱畸形进行直接三维矫正。本回顾性研究的目的是比较RLR与传统矫正技术(TCT)在两组青少年特发性脊柱侧凸(AIS)患者中的应用效果。
纳入2018年至2020年间的54例患者(男:女 = 1:8)。第一组(n = 22)采用RLR治疗,第二组(n = 32)采用TCT治疗。所有脊柱均按照Lenke系统进行分类。记录住院时间、重症监护病房(ICU)天数、手术时间和失血量。术前和术后采用SRS - 30和SF - 36问卷进行评估。收集影像学数据:术前和术后的Cobb角、冠状面和矢状面平衡、躯干和胸廓高度。
RLR组和TCT组在年龄(p = 0.317)、性别比例(p = 0.347)和Risser分期(p = 0.222)方面具有同质性。两组之间在血红蛋白值、住院时间、ICU天数、手术时间、SF - 36、SRS - 30、数字等级量表(NRS)和感知满意度方面无显著统计学差异。RLR组在主胸弯(MT)矫正方面有更好的改善(RLR 54.2% ± 15.9%/TCT 38.1% ± 20.4%,p = 0.031)。然而,RLR组的胸椎后凸矫正效果较差(RLR 16.82° ± 9.13°/27.12° ± 12.13°,p = 0.015)。
RLR系统比TCT系统能更有效地矫正MT曲线,但似乎会产生胸椎后凸不足的效果。