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[87例脊柱侧弯手术治疗回顾]

[Review of 87 cases of scoliosis surgically treated].

作者信息

Costanzo G, Savi Scarponi F, Fricano C

机构信息

Insegnamento Ortopedia e Traumatologia, Università degli Studi, L'Aquila.

出版信息

Minerva Med. 1997 Sep;88(9):335-42.

PMID:9411310
Abstract

BACKGROUND

The authors compared the results and complications in surgical treatment of idiopathic scoliosis with Harrington's rod instrumentation with subtrasversal wires in dorsal treat.

METHODS

A research on 87 cases operated on for idiopathic scoliosis from 1987 to 1995 is carried out. The 87 cases include 65 females and 25 males, 16 years old in average (range, 11 to 30). The curvature in Cobb's degrees and rotation of vertebrae with Raimondi's method on radiographs take just before, 15 days later and an year later on operation was measured. The patients have been divided into two groups: the first of 77 patients operated with Harrington's rod instrumentation; the second of 10 patients operated with Harrington's rod instrumentation and subtrasversal wires.

RESULTS

In a general analysis without taking in to consideration the type and the seriousness of curvature it was obtained a better correction and derotation of vertebrae in patients of second group. The same group with wires had obtained a better correction and derotation of vertebrae in dorsal scoliosis from 40 degrees to 60 degrees and in the double scoliosis, while the first group obtained better results in dorsal scoliosis from 60 degrees to 80 degrees and in derotation of vertebrae on dorsal treat of double scoliosis. One case of pseudarthrosis in every group was observed. Any neurological complication were observed.

CONCLUSIONS

The conclusions is drawn that the application of subtrasversal wire improves the Harrington's technique for the correction and derotation of dorsal and double scoliosis without neurological complications sometimes present with subliminar wires.

摘要

背景

作者比较了采用哈林顿棒器械及经椎弓根钢丝进行后路治疗特发性脊柱侧凸的手术结果及并发症。

方法

对1987年至1995年接受手术治疗的87例特发性脊柱侧凸患者进行研究。87例患者中,女性65例,男性25例,平均年龄16岁(范围11至30岁)。在术前、术后15天及术后1年拍摄X线片,采用雷蒙迪方法测量椎体的Cobb角及旋转度。患者分为两组:第一组77例采用哈林顿棒器械进行手术;第二组10例采用哈林顿棒器械及经椎弓根钢丝进行手术。

结果

在不考虑脊柱侧凸类型及严重程度的总体分析中,第二组患者的椎体矫正及去旋转效果更好。使用钢丝的同一组在40度至60度的胸段脊柱侧凸及双主弯中,椎体矫正及去旋转效果更好,而第一组在60度至80度的胸段脊柱侧凸及双主弯后路去旋转中效果更好。每组均观察到1例假关节病例。未观察到任何神经并发症。

结论

得出的结论是,经椎弓根钢丝的应用改进了哈林顿技术,可用于胸段及双主弯的矫正及去旋转,且不会出现有时与椎板下钢丝相关的神经并发症。

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