Deguchi M, Kawakami N, Kanemura T
Department of Orthopaedic Surgery, Nagoya University School of Medicine, Japan.
J Spinal Disord. 1997 Jun;10(3):197-203.
Experimental scoliosis with the potential for marked progression was treated by rib resection on the concave side of the curve, and the alterations of the rib cage and vertebrae in the transverse plane were investigated. Twenty-four chickens were divided into four equal groups (groups R, P, PR, and C) and pinealectomy was performed at 3 days of age in groups P and PR. In group R, three unilateral ribs were resected at the age of 4 weeks. In group PR, three ribs on the concave side of scoliosis were resected at 4 weeks of age if scoliosis of > 20 degrees developed before the age of 4 weeks. Group C served as a control. Spinal radiographs and computed tomography scans at the apical vertebrae were taken at 20 weeks of age, and spinal deformities were evaluated. Scoliosis developed markedly in groups R and P, whereas it was mild in group PR. The apical vertebrae rotated to the convex side of the curve in all groups, in the same way as it would in human idiopathic scoliosis. In group PR, the Cobb angle and the rotation angle of the apical vertebra were symmetrically suppressed. This study indicated that rib resection might control the progression of scoliosis not only in the frontal plane but also in the axial plane when it was done on the concave side of the scoliosis. Although this experiment succeeded in chickens, application in humans is uncertain.
对具有明显进展潜力的实验性脊柱侧弯采用在侧弯凹侧进行肋骨切除的方法进行治疗,并研究胸廓和椎体在横断面上的改变。将24只鸡分为四组(R组、P组、PR组和C组),P组和PR组在3日龄时进行松果体切除。R组在4周龄时切除三根单侧肋骨。在PR组中,如果在4周龄前出现大于20度的脊柱侧弯,则在4周龄时切除侧弯凹侧的三根肋骨。C组作为对照。在20周龄时拍摄脊柱X线片和上位椎体的计算机断层扫描,并评估脊柱畸形。R组和P组脊柱侧弯明显进展,而PR组则较轻。所有组的上位椎体均向侧弯凸侧旋转,与人类特发性脊柱侧弯的情况相同。在PR组中,上位椎体的Cobb角和旋转角得到对称抑制。本研究表明,当在脊柱侧弯凹侧进行肋骨切除时,不仅可以在额状面而且可以在矢状面控制脊柱侧弯的进展。虽然该实验在鸡身上取得了成功,但在人类中的应用尚不确定。