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青少年特发性脊柱侧凸Lenke 1B/1C型曲线的选择性与非选择性胸段融合术:2年随访的多中心临床和影像学分析

Selective Versus Non-Selective Thoracic Fusion for Adolescent Idiopathic Scoliosis Lenke 1B/1C Curves: Multi-Center Clinical and Radiographic Analysis at 2-Year Follow-Up.

作者信息

Miyaoka Yoshinari, Uehara Masashi, Banno Tomohiro, Seki Shoji, Ohba Tetsuro, Oba Hiroki, Ikegami Shota, Hatakenaka Terue, Kurogochi Daisuke, Fukuzawa Takuma, Mimura Tetsuhiko, Sasao Shinji, Haro Hirotaka, Kawaguchi Yoshiharu, Matsuyama Yukihiro, Takahashi Jun

机构信息

Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Nagano, Japan.

Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu 431-3192, Shizuoka, Japan.

出版信息

Medicina (Kaunas). 2025 May 17;61(5):909. doi: 10.3390/medicina61050909.

Abstract

: This retrospective cohort study compared selective thoracic fusion (STF) and non-STF for adolescent idiopathic scoliosis (AIS) Lenke 1B/1C curves. Although STF is considered an attractive option for patients with a compensatory lumbar curve, direct clinical comparisons between STF and non-STF remain limited. : AIS patients (≥2 years follow-up) undergoing posterior spinal fusion were divided into STF (57 cases) and non-STF (21 cases) groups. The correction rates of their main thoracic (MT) and thoracolumbar/lumbar (TL/L) curves, coronal balance, and SRS-22r scores were statistically compared. : Two years after the operation, while MT curve correction and coronal balance showed no significant differences, TL/L curve correction was significantly higher in the non-STF group. In contrast, the STF group had a significantly higher SRS-22r function score, with comparable results for self-image and satisfaction. : Both STF and non-STF present distinct characteristics that should be considered to optimize surgical decision-making.

摘要

这项回顾性队列研究比较了选择性胸椎融合术(STF)与非选择性胸椎融合术治疗青少年特发性脊柱侧凸(AIS)Lenke 1B/1C型曲线的效果。尽管STF被认为是治疗伴有代偿性腰椎曲线患者的一个有吸引力的选择,但STF与非STF之间的直接临床比较仍然有限。

接受后路脊柱融合术的AIS患者(随访≥2年)被分为STF组(57例)和非STF组(21例)。对两组患者的主胸弯(MT)和胸腰段/腰段(TL/L)曲线的矫正率、冠状面平衡以及SRS-22r评分进行了统计学比较。

术后两年,虽然MT曲线矫正和冠状面平衡无显著差异,但非STF组的TL/L曲线矫正显著更高。相比之下,STF组的SRS-22r功能评分显著更高,自我形象和满意度结果相当。

STF和非STF都有各自独特的特点,在优化手术决策时应予以考虑。

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