Liu Yingliang, Xu Changlei, Wang Yingsong, Zhao Zhi, Xie Jingming, Bi Ni, Xiao Jie, Tian Xiaobing
Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
Department of Orthopaedics, The People's Hospital of Chuxiong Yi Autonomous Prefecture, Chuxiong, Yunnan, China.
Medicine (Baltimore). 2025 Aug 29;104(35):e44134. doi: 10.1097/MD.0000000000044134.
This study aimed to explore skull-femoral traction and posterior vertebral column resection (PVCR) for the treatment of severe rigid scoliosis with trunk imbalance. The study also aimed to compare the procedure to the non-traction procedure with matched analysis. From January 2007 to December 2021, 59 patients (traction group) with severe rigid scoliosis and trunk imbalance underwent skull-femoral traction and PVCR. For comparison, another 1:1 matched group of 59 patients (non-traction group) was also retrospectively reviewed. These patients were treated with PVCR alone. The spinal function was assessed using the Scoliosis Research Society-Questionnaire. Differences were considered statistically significant at P < .05. The age of the traction and non-traction groups were 21.1 ± 8.2 years and 21.4 ± 10.3 years, respectively (P > .05). The duration of skull-femoral traction was 24 days (range, 14-39 days). The operative time was 521 ± 101 and 679 ± 443 minutes, respectively (P < .05). The amount of intraoperative blood loss was 987 ± 446 and 5961 ± 3214 mL, respectively (P < .05). The number of resected vertebrae was 0.4 ± 0.3 vs 1.1 ± 0.6 (P < .05). The groups were followed up for 34.9 ± 7.3 months and 31.1 ± 6.6 months, respectively (P > .05). The total Scoliosis Research Society-22 Questionnaire Scores were 4.7 (range, 3.8-5) and 4.5 (range, 3.3-5), respectively (P > .05). In the treatment of severe rigid scoliosis with trunk imbalance, preoperative skull-femoral traction improves curve flexibility of the spine, decreasing osteotomy grade, PVCR, average number of 3-column vertebrae resection, operative time, and intraoperative blood loss. However, both traction and non-traction techniques achieve similar spine correction and functional outcomes with similar complications and modalities.
本研究旨在探讨颅骨-股骨牵引联合后路脊柱全椎体切除术（PVCR）治疗重度僵硬型脊柱侧弯伴躯干失衡的效果。该研究还旨在通过匹配分析将该手术与非牵引手术进行比较。2007年1月至2021年12月，59例重度僵硬型脊柱侧弯伴躯干失衡患者（牵引组）接受了颅骨-股骨牵引及PVCR治疗。为作比较，另外对59例患者（非牵引组）进行了回顾性分析，该组患者为1:1匹配组，仅接受PVCR治疗。使用脊柱侧弯研究学会问卷对脊柱功能进行评估。P < 0.05时差异具有统计学意义。牵引组和非牵引组的年龄分别为21.1±8.2岁和21.4±10.3岁（P > 0.05）。颅骨-股骨牵引的持续时间为24天（范围为14 - 39天）。手术时间分别为521±101分钟和679±443分钟（P < 0.05）。术中失血量分别为987±446毫升和5961±3214毫升（P < 0.05）。切除椎体数量分别为0.4±0.3个和1.1±0.6个（P < 0.05）。两组的随访时间分别为34.9±7.3个月和31.1±6.6个月（P > 0.05）。脊柱侧弯研究学会22项问卷的总评分分别为4.7（范围为3.8 - 5）和4.5（范围为3.3 - 5）（P > 0.05）。在治疗重度僵硬型脊柱侧弯伴躯干失衡时，术前颅骨-股骨牵引可提高脊柱的弯曲灵活性，降低截骨分级、PVCR、三柱椎体平均切除数量、手术时间及术中失血量。然而，牵引和非牵引技术在脊柱矫正和功能结果方面相似，并发症及方式也相似。
