Edgar M A, Chapman R H, Glasgow M M
J Bone Joint Surg Br. 1982;64(5):530-5. doi: 10.1302/0301-620X.64B5.7142260.
One hundred and sixty-seven patients with adolescent idiopathic scoliosis were allocated prospectively to one of three different groups for correction before undergoing posterior spinal fusion and Harrington instrumentation, In group 1 single curves were corrected by a Risser turnbuckle plaster jacket and double curves by halo-pelvic traction. In Group 2 patients performed Cotrel dynamic traction for three weeks and this was followed by correction in a plaster cast. In Group 3 patients were given Cotrel dynamic traction for one week only and the operation was performed without a plaster cast. There was no significant difference in the overall correction achieved among the patients in the three groups except that double curves corrected slightly better in Group 2. The correction achieved by Cotrel dynamic traction after three weeks was not significantly different from that obtained at 48 hours. An anteroposterior radiograph of the spine taken during Cotrel dynamic traction was a valuable guide to the mobility of the curve and is preferable to radiographs of the patients bending laterally, particularly with respect to curves over 70 degrees. The paper concludes that correction before operation is not required routinely in adolescent idiopathic curves unless the deformity is a severe and rigid one in which case a radiograph during Cotrel traction is a useful assessment.
167例青少年特发性脊柱侧凸患者在接受后路脊柱融合和哈灵顿器械固定之前被前瞻性地分配到三个不同的组之一进行矫正。在第1组中，单曲线通过里塞尔旋转扣石膏夹克矫正，双曲线通过头盆牵引矫正。在第2组中，患者进行科特雷尔动态牵引三周，然后在石膏模型中进行矫正。在第3组中，患者仅接受科特雷尔动态牵引一周，并且在没有石膏模型的情况下进行手术。除了第2组中的双曲线矫正效果稍好之外，三组患者实现的总体矫正没有显著差异。科特雷尔动态牵引三周后的矫正效果与48小时时获得的矫正效果没有显著差异。在科特雷尔动态牵引期间拍摄的脊柱前后位X线片是曲线活动度的重要指导，并且比患者侧屈位X线片更可取，特别是对于超过70度的曲线。该论文得出结论，除非畸形严重且僵硬，否则青少年特发性曲线术前无需常规进行矫正，在这种情况下，科特雷尔牵引期间的X线片是一种有用的评估方法。
