Al Rashdan Amjad, Alessa Monther, Ababneh Faris, Al Taimeh Faisal, Althunaibat Zaid
Department of Orthopedics, Royal Medical Services, Amman, JOR.
Cureus. 2024 Mar 8;16(3):e55768. doi: 10.7759/cureus.55768. eCollection 2024 Mar.
Surgical correction of adolescent idiopathic scoliosis (AIS) using the facetectomy technique with the utilization of segmental pedicle screws aims to achieve correction of coronal and sagittal imbalances and preserve normal neurological function. In this study, we aimed to certify the effectiveness of the facetectomy technique in the correction of AIS by analyzing technique outcomes.
This is a retrospective, single-center study. From January 2018 to March 2022, a total of 51 patients with AIS who underwent inferior facetectomy with segmental pedicle screw constructs at the Royal Rehabilitation Center were reviewed. Radiological parameters including the major curve Cobb angle, and global coronal balance were evaluated preoperatively, postoperatively, and at the final follow-up. Surgical parameters and complications were also reported.
The mean major curve Cobb angle was 59.5 ± 4.9° preoperatively, 13.6 ± 2.7° postoperatively, and 14.5 ± 2.6° at the final follow-up, with correction rates of 77.2% and 75.7%, respectively. The mean global coronal balance was 2.7 ± 1.1 cm preoperatively, 1.7 ± 0.73 cm postoperatively, and 1.4 ± 0.55 cm at the final follow-up. Two cases of pleural injuries were reported intraoperatively. Postoperatively, two cases experienced superficial wound infections, one experienced pulmonary embolism, and one patient had revision surgery due to the loosening of a single screw. None of these complications lasted long.
When combined with posterior segmental pedicle screw constructs, inferior facetectomy can provide an effective rate of correction in a reasonably safe manner.
采用小关节切除术技术并结合节段性椎弓根螺钉对青少年特发性脊柱侧凸（AIS）进行手术矫正，旨在实现冠状面和矢状面失衡的矫正，并保留正常神经功能。在本研究中，我们旨在通过分析技术结果来验证小关节切除术技术在矫正AIS方面的有效性。
这是一项回顾性单中心研究。对2018年1月至2022年3月期间在皇家康复中心接受下小关节切除术并采用节段性椎弓根螺钉固定的51例AIS患者进行了回顾性分析。术前、术后及末次随访时评估了包括主弯Cobb角和整体冠状面平衡在内的影像学参数。还报告了手术参数和并发症情况。
术前主弯平均Cobb角为59.5±4.9°，术后为13.6±2.7°，末次随访时为14.5±2.6°，矫正率分别为77.2%和75.7%。术前平均整体冠状面平衡为2.7±1.1cm，术后为1.7±0.73cm，末次随访时为1.4±0.55cm。术中报告了2例胸膜损伤。术后，2例出现浅表伤口感染，1例发生肺栓塞，1例患者因单枚螺钉松动接受了翻修手术。这些并发症均未持续较长时间。
当与后路节段性椎弓根螺钉固定相结合时，下小关节切除术能够以合理安全的方式提供有效的矫正率。
