Cotrel Y, Dubousset J
Rev Chir Orthop Reparatrice Appar Mot. 1984;70(6):489-94.
The authors have designed a new method of instrumentation aimed at obtaining a surgical fixation of the scoliotic curve without any post-operative external support. It is particularly strong and rigid and allows an adequate reduction of the curve. This technique avoids the sublaminar space and thus prevents excessive blood loss and diminishes the danger of cord damage. The instrumentation is made of two parallel rough cylindrical rods inserted independently in the convexity and the concavity of the curve. If necessary they can be bent pre-operatively. They are attached to hooks placed on the laminae or pedicles which are locked by bolts thus allowing progressive straightening of the curve. They are joined by two transverse bars, one above and one below to provide better rigidity to the device and allow correction of rotation. The parts of the vertebrae left free by the device are denuded to allow the addition of grafts. Laboratory tests have demonstrated that this type of fixator is more rigid than the Harrington or Luque rods. Fifteen patients, either idiopathic or paralytic cases were operated on without any neurological impairment. No loss of correction was observed since the hooks have been locked.
作者设计了一种新的器械方法,旨在实现脊柱侧弯曲线的手术固定,且无需任何术后外部支撑。它特别坚固且刚性强,能充分矫正曲线。该技术避免了椎板下间隙,从而防止过多失血并降低脊髓损伤的风险。该器械由两根平行的粗糙圆柱形杆组成,分别独立插入曲线的凸侧和凹侧。如有必要,它们可在术前弯曲。它们通过置于椎板或椎弓根上的钩子固定,并用螺栓锁定,从而使曲线逐渐变直。它们由两根横杆连接,一根在上,一根在下,以增强器械的刚性并允许矫正旋转。器械未覆盖的椎骨部分进行剥离,以便添加植骨。实验室测试表明,这种类型的固定器比哈灵顿棒或鲁克棒更具刚性。15例患者,包括特发性或麻痹性病例,均接受了手术,且无任何神经功能损害。自钩子锁定后,未观察到矫正丢失。