Cummine J L, Lonstein J E, Moe J H, Winter R B, Bradford D S
J Bone Joint Surg Am. 1979 Dec;61(8):1151-61.
Fifty-nine adult patients were examined who had undergone previous spine surgery for scoliosis but in whom pain (78 per cent), loss of correction (68 per cent), or dyspnea (36 per cent) subsequently developed. Twenty-six patients had idiopathic scoliosis, twenty-five had paralytic scoliosis secondary to poliomyelitis, and eight had scoliosis secondary to miscellaneous etiologies. A one-stage reconstructive procedure was performed in sixteen patients and a two-stage procedure, in forty-three patients. The two-stage procedure consisted of exposure of the spine and multiple osteotomies, followed by two weeks of halofemoral traction to obtain correction. The spine fusion was then extended, using Harrington instrumentation to maintain correction. At an average follow-up of 3.3 years there was reduction of pain in 67 per cent of the patients and a solid fusion in all but two. The complication rate was high (71 per cent), the most important complications being pseudarthrosis, wound infection, urinary tract infections, loss of lumbar lordosis, and pressure sores. The mortality rate was 3.4 per cent. No patient became paraplegic at the initial surgical procedure and early recognition and treatment of pseudarthrosis will reduce the number of patients requiring this salvage operation.
对59例成年患者进行了检查，这些患者之前因脊柱侧弯接受过脊柱手术，但随后出现了疼痛（78%）、矫正丢失（68%）或呼吸困难（36%）。26例患者患有特发性脊柱侧弯，25例患有继发于脊髓灰质炎的麻痹性脊柱侧弯，8例患有继发于其他病因的脊柱侧弯。16例患者接受了一期重建手术，43例患者接受了两期手术。两期手术包括脊柱暴露和多次截骨，随后进行两周的股骨髁上牵引以获得矫正。然后使用哈灵顿器械延长脊柱融合以维持矫正。平均随访3.3年时，67%的患者疼痛减轻，除2例患者外其余患者均实现了牢固融合。并发症发生率较高（71%），最重要的并发症是假关节形成、伤口感染、尿路感染、腰椎前凸丢失和压疮。死亡率为3.4%。初次手术时没有患者发生截瘫，早期识别和治疗假关节将减少需要这种挽救性手术的患者数量。
