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新型脊柱畸形矫正操作系统,可更好地矫正大型特发性脊柱侧凸

A Novel Deformity Correction Manipulation System for Better Correction of Large Thoracic Scoliosis.

机构信息

Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China.

Department of Orthopedic Surgery, Pangang Group General Hospital, Panzhihua, China.

出版信息

Orthop Surg. 2024 Oct;16(10):2436-2446. doi: 10.1111/os.14169. Epub 2024 Jul 27.

Abstract

OBJECTIVE

Treating patients with large thoracic scoliosis (between 70° and 100°) poses technical challenges, particularly with traditional correction techniques (TCT). To address this, we developed a novel deformity correction manipulation system (DCMS) aimed at reducing surgical complexity and trauma. This study aims to assess the safety and effectiveness of DCMS in treating large thoracic scoliosis.

METHODS

From January 2016 to June 2021, 76 patients with large thoracic scoliosis were included in this retrospective study. The patients were divided into two groups: DCMS (n = 34) and TCT (n = 42). Basic patient data including age at surgery, sex, etiology, Risser sign, flexibility of the main thoracic curve, instrumented levels, number of screws, duration of hospital stay, and follow-up time were collected and analyzed. Radiographic and clinical outcomes, as measured by various radiographic parameters and Scoliosis Research Society-30 (SRS-30) scores, were retrospectively analyzed and compared between the two groups. Adverse events were also documented. Statistical analyses were performed using two-tailed independent t-tests, chi-square tests, and Fisher's exact test.

RESULTS

The DCMS group exhibited significantly shorter operative times, reduced blood loss, and shorter hospital stays compared to the TCT group. However, there were no significant differences between the two groups in terms of age at surgery, sex, etiology, Risser sign, flexibility of the main curve, instrumented levels, number of screws, and follow-up time. While preoperative major curves were statistically similar between the two groups, the DCMS group achieved a superior correction rate compared to the TCT group (74.2% ± 8.8% vs 68.1% ± 10.5%). No significant differences were observed in other radiographic parameters, SRS-30 scores, or the incidence of adverse events.

CONCLUSION

The application of DCMS resulted in shorter operative times, reduced blood loss, shorter hospital stays, and greater curve correction compared to TCT. DCMS proves to be a safe and effective technique for treating large thoracic curves.

摘要

目的

治疗大型胸弯(70°至 100°之间)的患者具有技术挑战,尤其是使用传统的矫正技术(TCT)。为了解决这个问题,我们开发了一种新的畸形矫正操作系统(DCMS),旨在降低手术的复杂性和创伤。本研究旨在评估 DCMS 在治疗大型胸弯中的安全性和有效性。

方法

从 2016 年 1 月至 2021 年 6 月,共有 76 例大型胸弯患者纳入本回顾性研究。患者分为两组:DCMS 组(n=34)和 TCT 组(n=42)。收集并分析了基本的患者数据,包括手术时的年龄、性别、病因、Risser 征、主胸弯的柔韧性、器械化水平、螺钉数量、住院时间和随访时间。通过各种影像学参数和脊柱侧凸研究协会 30 项评分(SRS-30),对两组患者的影像学和临床结果进行回顾性分析和比较。同时记录了不良事件。统计学分析采用双尾独立 t 检验、卡方检验和 Fisher 精确检验。

结果

与 TCT 组相比,DCMS 组的手术时间更短,失血量更少,住院时间更短。然而,两组在手术时的年龄、性别、病因、Risser 征、主曲线的柔韧性、器械化水平、螺钉数量和随访时间方面无显著差异。虽然两组患者术前的主要弯曲度相似,但 DCMS 组的矫正率明显优于 TCT 组(74.2%±8.8% vs 68.1%±10.5%)。其他影像学参数、SRS-30 评分和不良事件发生率两组间无显著差异。

结论

与 TCT 相比,应用 DCMS 可缩短手术时间、减少失血量、缩短住院时间并获得更大的弯曲矫正。DCMS 被证明是治疗大型胸弯的一种安全有效的技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddba/11456703/a19fdea221ab/OS-16-2436-g007.jpg

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