Department of Biomedical and Neuromotor Science-DIBINEM, 1st Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, University of Bologna, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.
Spine Deform. 2023 Jul;11(4):957-967. doi: 10.1007/s43390-023-00663-4. Epub 2023 Feb 22.
Retrospective cohort study.
to assess the efficacy and safety of Hi-PoAD technique in patients with a major thoracic curve > 90°, < 25% of flexibility and deformity spread over more than five vertebral levels.
retrospective review of AIS patients with a major thoracic curve (Lenke 1-2-3) > 90°, with < 25% of flexibility and deformity spread over more than five vertebral levels. All were treated via the Hi-PoAD technique. Radiographic and clinical score data were collected pre-operatively, operatively, at 1 year, 2 years and at last follow-up (2 years minimum).
19 patients were enrolled. A 65.0% correction rate of the main curve was achieved, from 101.9° to 35.7° (p < 0.001). The AVR reduced from 3.3 to 1.3. The C7PL/CSVL reduced from 1.5 to 0.9 cm (p = 0.013). Trunk Height increased from 31.1 to 37.0 cm (p < 0.001). At the final follow-up no significant changes, except from an improvement in C7PL/CSVL (from 0.9 cm to 0.6 cm; p = 0.017). SRS-22 increased in all patients, from 2.1 to 3.9 at 1 year of follow-up (p < 0.001). 3 patients had a transient drop of MEP and SEP during maneuver and were managed with temporary rods and a second surgery after 5 days. 2 of these 3 cases (66.7%) had a Total-Deformity Angular Ratio (T-DAR) > 25; conversely, among patients who had a one-stage procedure, only 1 (6.2%) had a T-DAR > 25 (p = 0.008).
The Hi-PoAD technique proved to be a valid alternative for the treatment of severe, rigid AIS involving more than 5 vertebral bodies.
Retrospective comparative cohort study.
III.
回顾性队列研究。
评估 Hi-PoAD 技术在主胸弯>90°、<25%柔韧性且畸形分布超过 5 个椎体水平的患者中的疗效和安全性。
回顾性分析主胸弯（Lenke 1-2-3）>90°、<25%柔韧性且畸形分布超过 5 个椎体水平的 AIS 患者。所有患者均采用 Hi-PoAD 技术治疗。术前、术后、1 年、2 年和末次随访（至少 2 年）收集影像学和临床评分数据。
共纳入 19 例患者。主弯矫正率为 65.0%，从 101.9°降至 35.7°（p<0.001）。AVR 从 3.3 降至 1.3。C7PL/CSVL 从 1.5 降至 0.9cm（p=0.013）。躯干高度从 31.1 增加到 37.0cm（p<0.001）。末次随访时，除 C7PL/CSVL 略有改善（从 0.9cm 降至 0.6cm；p=0.017）外，无明显变化。所有患者 SRS-22 均增加，从 1 年随访时的 2.1 增加到 3.9（p<0.001）。3 例患者在操作过程中出现短暂的运动诱发电位和体感诱发电位下降，采用临时棒和 5 天后再次手术进行治疗。这 3 例中有 2 例（66.7%）的总畸形角比（T-DAR）>25%；相反，在一期手术的患者中，只有 1 例（6.2%）的 T-DAR>25%（p=0.008）。
Hi-PoAD 技术是治疗涉及超过 5 个椎体的严重僵硬 AIS 的有效替代方法。
回顾性对比队列研究。
III 级。
