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[阿姆斯特朗与哈林顿技术治疗特发性脊柱侧凸的对比研究]

[Comparative study of the Armstrong and Harrington technics in the treatment of idiopathic scolioses].

作者信息

Lascombes P, Prévot J, Kuhnast M, Guillaumot M, Ligier J N

出版信息

Chir Pediatr. 1986;27(2):69-74.

PMID:3742696
Abstract

Between 1982 and 1985, idiopathic scoliosis was treated by instrumentation using Armstrong's technique, segmental spinal instrumentation (Luque's method) being reserved for neuromuscular scoliosis. Of the 29 patients treated by the technique 22 have been followed up for more than 18 months. Results were compared with those in a similar group of 30 patients operated upon using Harrington's original procedure between 1977 and 1982. This retrospective study complements that of Michel et al., and provided the following results: Although the instrumental correction gain was comparable in the two groups after 2 years, the angular loss was less marked by 3.4 degrees in the Armstrong when compared with the Harrington group. In addition, this mounting offers stability of lumbar contra-curvatures of which there is a lack of deterioration. Horizontalization of the lower load-bearing vertebra was better in the Armstrong group and allowed the choice of a load-bearing vertebra above that of the Harrington's group in two-thirds of cases. The changes in vertebral rotation and gibbosity are supplementary advantages of Armstrong's technique. Postoperative contention is still necessary, whatever technique is used, but the use of a second branch placed in distraction in the convexity is recommended, to improve quality of surgical treatment of idiopathic scoliosis.

摘要

1982年至1985年间,采用阿姆斯特朗技术通过器械治疗特发性脊柱侧凸,节段性脊柱器械固定术(鲁克法)则用于治疗神经肌肉型脊柱侧凸。在采用该技术治疗的29例患者中,22例随访时间超过18个月。将结果与1977年至1982年间采用哈林顿原始手术方法治疗的30例类似患者的结果进行了比较。这项回顾性研究补充了米歇尔等人的研究,并得出以下结果:尽管两组在2年后器械矫正增益相当,但与哈林顿组相比,阿姆斯特朗组的角度丢失少3.4度,不那么明显。此外,这种固定方式能使腰椎反向弯曲保持稳定,不会恶化。阿姆斯特朗组中较低承重椎体的水平化更好,在三分之二的病例中,可以选择高于哈林顿组的承重椎体。椎体旋转和驼背的改善是阿姆斯特朗技术的额外优势。无论采用何种技术,术后固定仍然是必要的,但建议在凸侧使用第二个撑开分支,以提高特发性脊柱侧凸的手术治疗质量。

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