Christodoulou A G, Kapetanos G, Apostolou T, Pournaras J, Symeonides P P
Department of Orthopaedic Surgery, University of Thessaloniki, School of Medicine, Greece.
Acta Orthop Scand Suppl. 1997 Oct;275:3-7.
30 patients with idiopathic scoliosis were treated by posterior spinal arthrodesis using the Luque (8 patients) and Hartshill (22 patients) rodding systems with sublaminar segmental wiring. Patients were followed for 2 to 6 years. In most cases, postoperative correction exceeded safety correction limits (lateral bending film plus 10 degrees). Final correction was 55%, while derotation was not significant (average 3 degrees). No neurological deficit was noted. Postoperative bracing was not applied and there was 1 patient with broken rods (Luque trolley system without fusion) and 1 patient with broken wires in 4 segments. Allogenic blood transfusion was avoided in 19 patients by preoperative donation of autologous blood, in combination with salvage of intraoperative shed blood. We found segmental spinal wiring with either rods or rectangles to be a safe method for correction of scoliosis in experienced hands. It offered satisfactory stability and fusion rate with no need for external support.
30例特发性脊柱侧凸患者采用Luque(8例)和Hartshill(22例)棒系统及椎板下节段钢丝固定进行后路脊柱融合术。对患者进行了2至6年的随访。在大多数情况下,术后矫正超过了安全矫正限度(侧位弯曲片加10度)。最终矫正率为55%,而旋转矫正不明显(平均3度)。未发现神经功能缺损。术后未应用支具,有1例患者出现棒折断(Luque推车系统未融合),1例患者4个节段钢丝折断。19例患者通过术前自体血捐献并结合术中回收失血避免了异体输血。我们发现,在经验丰富的医生手中,使用棒或矩形进行节段性脊柱钢丝固定是一种矫正脊柱侧凸的安全方法。它提供了令人满意的稳定性和融合率,无需外部支撑。