Dohin B, Dubousset J F
Department of Paediatric Surgery, General Hospital, Le Mans, France.
Eur Spine J. 1994;3(3):165-8. doi: 10.1007/BF02190580.
The aim of this study was to determine whether an anterior approach to the spine with a fusion of the growth centers of the anterior column of the spine, simultaneous by with a posterior fusion and instrumentation of the spine, in young patients with severe scoliosis who have considerable remaining growth, leads to prevention of the crankshaft phenomenon. Twelve patients who have had anterior fusion of the spine associated with posterior fusion and instrumentation of the spine were studied. In 10 of them, growth progression was demonstrated by modification of the Risser sign; for these patients no important progression of the spinal deformity was noted. One patient had no progression of the Risser sign and no progression of spinal deformity. One patient had progression of spinal deformity due to the disruption of the sacral anchorage of instrumentation. We think that this procedure leads to the prevention of the crankshaft phenomenon, and we recommend this procedure in young patients with severe scoliosis and considerable remaining growth. It must include all intervertebral levels of the rigid segment of the curve.
本研究的目的是确定，对于仍有大量生长潜力的重度脊柱侧弯年轻患者，采用前路脊柱手术并融合脊柱前柱生长中心，同时后路融合并进行脊柱内固定，是否能预防曲轴现象。对12例接受了脊柱前路融合并后路融合及内固定的患者进行了研究。其中10例患者的Risser征改变表明生长进展；这些患者未观察到脊柱畸形的显著进展。1例患者Risser征无进展，脊柱畸形也无进展。1例患者因内固定骶骨锚固破坏导致脊柱畸形进展。我们认为该手术可预防曲轴现象，建议对有大量生长潜力的重度脊柱侧弯年轻患者采用此手术。该手术必须包括弯曲僵硬节段的所有椎间水平。
