Bernstein R M, Hall J E
Shriners Hospital for Children, Los Angeles, California, USA.
J Pediatr Orthop B. 1998 Apr;7(2):124-31. doi: 10.1097/01202412-199804000-00006.
Seventeen patients with adolescent idiopathic thoracolumbar scoliosis underwent short segment anterior spinal fusion with a solid rod-screw construct. Patients were evaluated radiographically and interviewed using the Scoliosis Research Society instrument. Mean radiographic follow-up was 34 months, and mean follow-up at time of interview was 62 months. Mean curve correction was 87%, declining to 67% at 2 years. Mean correction of the instrumented curve was 114%, declining to 103% at 2 years. The thoracic curve improved 24% and remained stable throughout the follow-up period. Kyphosis over the instrumented segments increased from 4 degrees preoperatively to 10 degrees postoperatively. Although there was a trend toward increasing kyphosis over time, this was not statistically significant at final follow-up. Most patients (88%) were extremely satisfied with the surgical result. We believe that a short-segment anterior fusion with a solid rod-screw construct provides excellent curve correction with minimal kyphosis over the instrumented segment. Overcorrection of the instrumented segment must be achieved for this technique to be successful.
17例青少年特发性胸腰段脊柱侧凸患者接受了短节段前路脊柱融合术，采用坚固的棒-螺钉结构。对患者进行了影像学评估，并使用脊柱侧凸研究学会的工具进行了访谈。影像学平均随访时间为34个月，访谈时的平均随访时间为62个月。平均曲线矫正率为87%，2年后降至67%。器械矫正曲线的平均矫正率为114%，2年后降至103%。胸段曲线改善了24%，在整个随访期间保持稳定。器械固定节段的后凸从术前的4度增加到术后的10度。尽管随着时间的推移后凸有增加的趋势，但在最终随访时这一差异无统计学意义。大多数患者（88%）对手术结果非常满意。我们认为，采用坚固的棒-螺钉结构进行短节段前路融合术可提供良好的曲线矫正效果，且器械固定节段的后凸最小。要使该技术成功，必须实现器械固定节段的过度矫正。
