Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Xiangya Road 87, Changsha, China.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Xiangya Road 87, Changsha, China.
J Orthop Surg Res. 2023 Oct 19;18(1):786. doi: 10.1186/s13018-023-04285-4.
Many patients with neuromuscular scoliosis (NMS) experience a variety of difficult medical problems that aggravate the development effects of progressive scoliosis and pelvic obliquity (PO). The objective of the current study was to assess the safety and effectiveness of multi-rod posterior correction only (MRPCO) with halo-femoral traction (HFT) for the management of adult NMS (> 100°) with severe PO.
From 2012 to 2017, 13 adult patients who suffered from NMS (> 100°) with severe PO underwent MRPCO with HFT. The radiography parameters in a sitting position, such as the coronal Cobb angle of the main curve, the PO and the trunk shift (TS), were measured at the preoperative, postoperative and final follow-up stages. The preoperative and final follow-up assessment of the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) was taken.
The average follow-up span was 68.15 ± 6.78 months. There was decreased postoperative coronal Cobb angle with an average mean of 125.24° ± 11.78° to 47.55° ± 12.10°, with a correction rate of 62.43%; the PO was reduced to 6.25° ± 1.63° from 36.93° ± 4.25° with a correction rate of 83.07%; the TS was reduced to 2.41 cm ± 1.40 cm from 9.19 cm ± 3.07 cm. There was significant improvement in all parameters compared to the preoperative data. The VAS score reduced from 4.77 ± 0.93 to 0.69 ± 0.75, and the ODI score reduced from 65.38 ± 16.80 to 28.62 ± 12.29 at the final follow-up.
Treatment of adult NMS (> 100°) with severe PO could be safe and effective with MRPCO with HFT. In order to obtain the optimum sitting balance, this could reduce the prevalence of complications and rectify the curvature and the correction of PO.
许多神经肌肉性脊柱侧凸（NMS）患者存在多种严重的医疗问题，这些问题加剧了进展性脊柱侧凸和骨盆倾斜（PO）的发展影响。本研究的目的是评估后路多棒矫正加头环股骨牵引（HFT）治疗成人 NMS（>100°）伴严重 PO 的安全性和有效性。
2012 年至 2017 年，13 例 NMS（>100°）伴严重 PO 的成年患者接受后路多棒矫正加 HFT 治疗。在术前、术后和最终随访阶段，测量坐位冠状 Cobb 角、PO 和躯干偏移（TS）等影像学参数。术前和最终随访时采用视觉模拟评分（VAS）和 Oswestry 功能障碍指数（ODI）进行评估。
平均随访时间为 68.15±6.78 个月。术后冠状 Cobb 角平均由 125.24°±11.78°减小至 47.55°±12.10°，矫正率为 62.43%；PO 由 36.93°±4.25°减小至 6.25°±1.63°，矫正率为 83.07%；TS 由 9.19±3.07 cm 减小至 2.41±1.40 cm。与术前相比，所有参数均有显著改善。VAS 评分由 4.77±0.93 降至 0.69±0.75，ODI 评分由 65.38±16.80 降至 28.62±12.29。
后路多棒矫正加 HFT 治疗成人 NMS（>100°）伴严重 PO 安全有效。为了获得最佳的坐姿平衡，可以减少并发症的发生率，矫正脊柱侧凸和 PO 的矫正。
