Suk S I, Lee C K, Kim W J, Chung Y J, Park Y B
Department of Orthopaedic Surgery, Seoul National University, College of Medicine, Korea.
Spine (Phila Pa 1976). 1995 Jun 15;20(12):1399-405.
This retrospective clinical study compared the results of correction of idiopathic thoracic scoliosis using Cotrel-Dubousset segmental pedicle screw fixation with those of hooks and screws inserted in a hook pattern.
The study's objective was to evaluate the efficacy and safety of segmental pedicle screw fixation in the management of idiopathic thoracic scoliosis.
Seventy-eight idiopathic thoracic scoliosis patients were treated with Cotrel-Dubousset instrumentation from 1987 to 1991. Thirty-one were treated with hooks; 23 were treated with pedicle screws inserted in a hook pattern; and 24 were treated with segmental pedicle screws.
After a minimum follow-up of 2 years (range, 25-52 months), the results of frontal, sagittal, and rotational correction of each group were compared and statistically analyzed using analysis of variance.
Major curve correction was 55% with hooks, 66% with hook pattern screws, and 72% with segmental screws, with loss of correction of 6%, 2%, and 1%, respectively. Compensatory curve correction was 57% with hooks, 67% with hook pattern screws, and 70% with segmental pedicle screws. In patients with hypokyphosis, all showed significant improvement with best restoration in segmental screws. Rotational correction of the apical vertebra measured by the Perdriolle method was 19% with hooks, 26% with hook pattern screws, and 59% with segmental screws. Thirteen screws (3%) were malpositioned, but they did not cause neurologic impairment or adversely affect the results of treatment.
Segmental pedicle screw fixation is a safe and effective method for correcting the triplanar deformity of the idiopathic thoracic scoliosis.
这项回顾性临床研究比较了使用 Cotrel-Dubousset 节段性椎弓根螺钉固定术与以钩形方式插入钩和螺钉治疗特发性胸椎侧弯的结果。
本研究的目的是评估节段性椎弓根螺钉固定术治疗特发性胸椎侧弯的疗效和安全性。
1987 年至 1991 年期间，78 例特发性胸椎侧弯患者接受了 Cotrel-Dubousset 器械治疗。31 例采用钩治疗；23 例采用以钩形方式插入的椎弓根螺钉治疗；24 例采用节段性椎弓根螺钉治疗。
在至少随访 2 年（范围为 25 - 52 个月）后，比较每组的额状面、矢状面和旋转矫正结果，并使用方差分析进行统计学分析。
钩治疗的主弯矫正率为 55%，钩形螺钉治疗为 66%，节段性螺钉治疗为 72%，矫正丢失率分别为 6%、2%和 1%。代偿弯矫正率钩治疗为 57%，钩形螺钉治疗为 67%，节段性椎弓根螺钉治疗为 70%。在胸椎后凸不足的患者中，所有患者均有显著改善，节段性螺钉组恢复最佳。采用 Perdriolle 方法测量的顶椎旋转矫正率，钩治疗为 19%，钩形螺钉治疗为 26%，节段性螺钉治疗为 59%。13 枚螺钉（3%）位置不当，但未导致神经损伤或对治疗结果产生不利影响。
节段性椎弓根螺钉固定术是矫正特发性胸椎侧弯三平面畸形的一种安全有效的方法。
