Hernández Mateo José María, Flores Gallardo Jaime, Riquelme García Oscar, García Martín Azucena, Igualada Blázquez Cristina, Solans López María Coro, Muñoz Núñez Laura, Esparragoza Cabrera Luis Alejandro
Department of Traumatology and Orthopaedic Surgery, General University Hospital Gregorio Marañón, Madrid, Spain.
Department of Spine Surgery, General University Hospital Gregorio Marañón, Madrid, Spain.
J Spine Surg. 2024 Jun 21;10(2):224-231. doi: 10.21037/jss-23-128. Epub 2024 May 9.
BACKGROUND: "Convex Pedicle Screw Technique" reduces the theoretical risk of neurovascular injury. Our aim is to evaluate the efficacy of this technique in patients with neuromuscular scoliosis (NMS). METHODS: Retrospective study of 12 patients who underwent a Convex Pedicle Screw Technique and were diagnosed with NMS. Patients who had undergone previous spinal surgery were excluded. The minimum follow-up required was 24 months. Demographic data, intraoperative data, neurovascular complications and neurophysiological events requiring implant repositioning, as well as pre- and postoperative radiological variables were collected. RESULTS: Twelve patients diagnosed with NMS underwent surgery. The median operative time was 217 minutes. Mean blood loss was 3.8±1.1 g/dL hemoglobin (Hb). The median postoperative stay was 8.8±4 days. A reduction of the Cobb angle in primary curve of 49.1% (from 52.8°±18° to 26.5°±12.6°; P<0.001) and in secondary curve of 25.2% (from 27.8°±18.9° to 18.3°±13.3°; P=0.10) was achieved. Coronal balance improved by 69.4% (7.5±46.2 2.3±20.9 mm; P=0.72) and sagittal balance by 75% (from -14.1±71.8 -3.5±48.6 mm; P=0.50). There were no neurovascular complications. There were no intraoperative neurophysiological events requiring implant repositioning, nor during reduction maneuvers. No infections were reported. CONCLUSIONS: The correction of the deformity from convexity in NMS achieves similar results to other techniques, and a very low complication rate.
背景:“凸侧椎弓根螺钉技术”降低了神经血管损伤的理论风险。我们的目的是评估该技术在神经肌肉型脊柱侧凸(NMS)患者中的疗效。 方法:对12例行凸侧椎弓根螺钉技术且诊断为NMS的患者进行回顾性研究。排除既往接受过脊柱手术的患者。所需的最短随访时间为24个月。收集人口统计学数据、术中数据、神经血管并发症以及需要重新调整植入物位置的神经生理事件,以及术前和术后的放射学变量。 结果:12例诊断为NMS的患者接受了手术。中位手术时间为217分钟。平均失血量为血红蛋白(Hb)3.8±1.1 g/dL。术后中位住院时间为8.8±4天。主弯的Cobb角减小了49.1%(从52.8°±18°降至26.5°±12.6°;P<0.001),次弯减小了25.2%(从27.8°±18.9°降至18.3°±13.3°;P=0.10)。冠状面平衡改善了69.4%(从7.5±46.2变为2.3±20.9 mm;P=0.72),矢状面平衡改善了75%(从-14.1±71.8变为-3.5±48.6 mm;P=0.50)。没有神经血管并发症。术中及复位操作过程中均未发生需要重新调整植入物位置的神经生理事件。未报告感染情况。 结论:NMS凸侧畸形的矫正与其他技术取得的结果相似,且并发症发生率极低。
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