Brumat Peter, Mohar Janez, Čeleš Dejan, Erdani Danijel, Hero Nikša, Topolovec Matevž
Valdoltra Orthopaedic Hospital, 6280 Ankaran, Slovenia.
Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia.
Healthcare (Basel). 2023 Apr 17;11(8):1149. doi: 10.3390/healthcare11081149.
The study aimed to assess long-term radiological outcomes in patients from our institution who were primarily treated for adolescent idiopathic scoliosis with surgical correction using Harrington rod (HR) instrumentation, and afterward with watchful waiting of residual spinal deformity after HR removal, whereby no patient consented to spinal deformity correction. A single-institution case series of 12 patients was retrospectively evaluated. Preoperative and most recent post-instrumentation removal radiographic measurements were compared, along with baseline characteristics. The average age of patients (all females) at the time of HR instrumentation removal was 38 ± 10 years (median 40, range 19-54). The mean follow-up from the HR instrumentation implantation to the HR instrumentation removal was 21 ± 10 years (median 25, range 2-37), with a further mean of 11 ± 10 years (median 7, range 2-36) of follow-up following HR instrumentation removal and watchful waiting. No significant change in radiological parameters was observed: LL ( = 0.504), TK ( = 0.164), PT ( = 0.165), SS ( = 0.129), PI ( = 0.174), PI-LL ( = 0.291), SVA ( = 0.233), C7-CSVL ( = 0.387), SSA ( = 0.894), TPA ( = 0.121), and coronal Cobb angle (proximal ( = 0.538), main thoracic ( = 0.136), and lumbar ( = 0.413)). No significant change in coronal or sagittal parameters was observed in this single-institution long-term radiological outcome study of adults following HR instrumentation removal and watchful waiting of residual spinal deformity.
本研究旨在评估我院主要接受哈灵顿棒（HR）器械手术矫正青少年特发性脊柱侧凸的患者的长期放射学结果，术后对HR取出后残留的脊柱畸形进行观察等待，期间无患者同意进行脊柱畸形矫正。对一个单机构的12例患者病例系列进行回顾性评估。比较术前和器械取出后最近的影像学测量结果以及基线特征。HR器械取出时患者（均为女性）的平均年龄为38±10岁（中位数40岁，范围19 - 54岁）。从HR器械植入到取出的平均随访时间为21±10年（中位数25年，范围2 - 37年），HR器械取出并观察等待后进一步的平均随访时间为11±10年（中位数7年，范围2 - 36年）。未观察到放射学参数有显著变化：腰椎前凸（ = 0.504）、胸椎后凸（ = 0.164）、骨盆倾斜度（ = 0.165）、骶骨斜率（ = 0.129）、骨盆入射角（ = 0.174）、骨盆入射角与腰椎前凸差值（ = 0.291）、矢状面垂直轴（ = 0.233）、C7至矢状面垂直线距离（ = 0.387）、脊柱矢状面轴向旋转（ = 0.894）、胸椎平面轴向旋转（ = 0.121）以及冠状面Cobb角（近端（ = 0.538）、胸主弯（ = 0.136）和腰弯（ = 0.413））。在这项针对成人HR器械取出及对残留脊柱畸形进行观察等待的单机构长期放射学结果研究中，未观察到冠状面或矢状面参数有显著变化。
