Lenke L G, Bridwell K H, Blanke K, Baldus C, Weston J
Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
J Bone Joint Surg Am. 1998 Jun;80(6):807-14. doi: 10.2106/00004623-199806000-00004.
We evaluated the radiographic results of posterior spinal arthrodesis with use of Cotrel-Dubousset instrumentation in seventy-six patients who had adolescent idiopathic scoliosis. At an average of six years (range, five to ten years) postoperatively, the fusion appeared to be solid in all patients. Comparison of radiographs that had been made immediately postoperatively with those that had been made at the time of the latest follow-up showed that no patient had lost any correction in the coronal plane at the levels with instrumentation and seventy-five had had no change in the thoracic or lumbar sagittal alignment at the levels with or without instrumentation. In the remaining patient, a kyphosis had developed at the junction of the segments with instrumentation and those without instrumentation, necessitating additional operative treatment. Sixty-three patients completed a questionnaire for assessment of the clinical status. Their responses were favorable with regard to function, cosmetic appearance, and general satisfaction with the operative result. Twenty-four (38 per cent) of the sixty-three patients reported occasional pain in the spine that did not interfere with work or school activities. Sixty-two patients stated that, given the hypothetical situation of reverting to the preoperative status, they would have the operation again.
我们评估了76例青少年特发性脊柱侧凸患者使用Cotrel-Dubousset器械进行后路脊柱融合术的影像学结果。术后平均6年(范围5至10年),所有患者的融合似乎都很牢固。将术后即刻拍摄的X线片与最近一次随访时拍摄的X线片进行比较,结果显示,在使用器械的节段,没有患者在冠状面丢失任何矫正度数,75例患者在使用或未使用器械的节段,胸段或腰段矢状位排列没有变化。在其余患者中,在使用器械和未使用器械的节段交界处出现了后凸,需要进一步的手术治疗。63例患者完成了一份评估临床状况的问卷。他们对功能、外观及手术结果的总体满意度的回答是肯定的。63例患者中有24例(38%)报告脊柱偶尔疼痛,但不影响工作或学校活动。62例患者表示,假设恢复到术前状态,他们仍会再次接受手术。