Shufflebarger H L, Clark C E
Department of Orthopedics and Rehabilitation, University of Miami School of Medicine, Coral Gables, FL 33146, USA.
J Pediatr Orthop B. 1998 Apr;7(2):117-23. doi: 10.1097/01202412-199804000-00005.
Wide lumbar posterior release, consisting of partial excision of spinous process, excision of interspinous ligament and ligamentum flavum, and excision of facet in plane of facet from both outside and within the spinal canal has been employed to increase coronal correction and improve the production of lumbar lordosis (10). Adolescent idiopathic patients with fusion into the lumbar spine were studied. Pre- and postsurgical coronal and sagittal Cobb measurements as well bending measurements were done. Intraoperative biplanar radiographs were done after positioning, after lumbar rod placement, and finally after wide release and placement of the same rod. Statistical analysis was by paired Student's t-test. Significantly (p < 0.005), improved correction was attained in the coronal plane with release (76% vs. 64%). Total lordosis and instrumented segment lordosis was also significantly (p < 0.025) improved with release (12 degrees vs. 3 degrees). Coronal and sagittal plane correction in the lumbar spine is improved significantly with a wide posterior lumbar release.
广泛的腰椎后路松解术，包括棘突部分切除、棘间韧带和黄韧带切除，以及从椎管内外在关节突平面切除关节突，已被用于增加冠状面矫正并改善腰椎前凸的形成（10）。对融合至腰椎的青少年特发性患者进行了研究。术前和术后进行了冠状面和矢状面的Cobb测量以及侧弯测量。术中在体位摆放后、腰椎棒置入后，以及最后在广泛松解并置入同一根棒后进行了双平面X线片检查。统计分析采用配对学生t检验。显著地（p < 0.005），松解后冠状面矫正得到改善（76% 对 64%）。总前凸和器械固定节段的前凸也因松解而显著（p < 0.025）改善（12度对3度）。广泛的腰椎后路松解术能显著改善腰椎的冠状面和矢状面矫正。
