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缩短术后严格固定时间在特发性脊柱侧凸手术治疗中的应用。

The use of shortened periods of rigid postoperative immobilization in the surgical treatment of idiopathic scoliosis.

作者信息

Tolo V, Gillespie R

出版信息

J Bone Joint Surg Am. 1981 Sep;63(7):1137-45.

PMID:7276049
Abstract

Seventy-eight consecutive patients with idiopathic scoliosis treated by Harrington instrumentation and spine fusion were allowed to walk shortly after operation, first in an underarm plaster cast for ten weeks and then in a canvas-front, hard-back Rohadur or Lexan brace until all external support was discontinued six months after operation. Sixty-four patients were followed for two years or more. Single thoracic curves, comprising almost half of the series, had an average final correction of 48 per cent, while all curves had an average final correction of 44 per cent. The average total loss of correction was 8 degrees, with approximately equal amounts lost in the first and second three months after operation. The incidence of pseudarthrosis was 1.5 per cent and the complications were minor. This series demonstrated that, for cooperative patients with idiopathic scoliosis of less than 90 degrees, the operative procedure and postoperative immobilization described can be expected to result in solid fusion without excessive loss of initial correction, pleasing cosmetic results, and less inconvenience to the patient because of decreased time in a plaster cast and early ambulation.

摘要

78例接受哈林顿器械植入和脊柱融合术治疗的特发性脊柱侧凸患者术后不久即开始行走,最初在腋下石膏固定10周,然后佩戴前侧为帆布、后侧为硬壳的Rohadur或Lexan支具,直至术后6个月停止所有外部支撑。64例患者随访2年或更长时间。单胸弯患者占该系列的近一半,平均最终矫正率为48%,而所有侧弯的平均最终矫正率为44%。矫正的平均总丢失度数为8度,术后前三个月和第二个三个月丢失的度数大致相等。假关节发生率为1.5%,并发症轻微。该系列表明,对于合作的、特发性脊柱侧凸小于90度的患者,所述的手术方法和术后固定有望实现牢固融合,而不会过度丢失初始矫正度数,获得令人满意的美容效果,并且由于减少了石膏固定时间和早期行走,给患者带来的不便也更少。

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