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青少年特发性脊柱侧凸矫正中直接椎体旋转与单纯棒旋转技术的对比

Direct vertebral rotation versus simple rod derotation techniques in correction of adolescent idiopathic scoliosis.

作者信息

Abdel Rasol Asem Mahmoud Sayed, El Badrawi Ahmed Mohamed, Abdel Latif Ali Ibrahim, Fahmy Fady Michael, Zahlawy Hany El, Hussien Mohammed Ali

机构信息

Orthopedic Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

出版信息

Spine Deform. 2024 Jul;12(4):1061-1070. doi: 10.1007/s43390-024-00841-y. Epub 2024 Mar 20.

Abstract

BACKGROUND

One method for treating adolescent idiopathic scoliosis (AIS), which is characterized by abnormal spinal alignment in the coronal, sagittal, and rotational planes, is surgical correction. The two surgical techniques most typically used to correct spine alignment are simple rod derotation (SRD) and direct vertebral derotation (DVR).

AIM

The study's goal was to assess the effectiveness of two treatment methods for adolescent idiopathic scoliosis: simple rod derotation and direct vertebral rotation.

SUBJECTS AND METHODS

A randomized controlled research involving 36 adolescents with idiopathic scoliosis was done. Patients were randomly split into one of two groups: 18 patients in group A had DVR treatment, while 18 patients in group B received SRD with a 2-year follow-up.

RESULTS

Apical Vertebral Rotation measured from CT scans in DVR group was 24.4° ± 8.38° preoperatively and it decreased significantly postoperatively to 14.4° ± 4.61° with (42.22%) correction rate, while in SRD group, it was 25.03° ± 7.99° preoperatively and it also decreased significantly postoperatively to a mean value of 21.41° ± 7.01° with (14.65%) correction rate. There were statistically significant differences between both groups post-operative (P < 0.001).

CONCLUSION

The apical vertebral rotation was greatly enhanced in both procedures, with direct vertebral rotation being better. Both Simple rod derotation and direct vertebral rotation reduce the rib hump, although the improvement is much greater with direct vertebral rotation.

摘要

背景

青少年特发性脊柱侧弯(AIS)的特征是脊柱在冠状面、矢状面和旋转面出现异常排列,其一种治疗方法是手术矫正。最常用于矫正脊柱排列的两种手术技术是简单棒旋转去旋转术(SRD)和直接椎体去旋转术(DVR)。

目的

本研究的目的是评估青少年特发性脊柱侧弯的两种治疗方法的有效性:简单棒旋转去旋转术和直接椎体旋转术。

对象与方法

进行了一项涉及36名特发性脊柱侧弯青少年的随机对照研究。患者被随机分为两组之一:A组18例患者接受DVR治疗,而B组18例患者接受SRD治疗,并进行了2年的随访。

结果

DVR组术前CT扫描测量的顶椎旋转角度为24.4°±8.38°,术后显著降低至14.4°±4.61°,矫正率为(42.22%);而在SRD组,术前为25.03°±7.99°,术后也显著降低至平均值21.41°±7.01°,矫正率为(14.65%)。两组术后差异有统计学意义(P<0.001)。

结论

两种手术方法均能显著改善顶椎旋转,直接椎体旋转术效果更佳。简单棒旋转去旋转术和直接椎体旋转术均能减少肋骨隆起,不过直接椎体旋转术的改善程度更大。

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