Max Prost, Philip Denz, Joachim Windolf, Markus Rafael Konieczny
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引用次数: 0
Abstract
Background: Surgical correction of adolescent idiopathic scoliosis from the posterior approach can be performed by the "all screws" technique; hybrid technique with screws and hooks; hybrid technique or with screws, hooks, and tapes; or selective fusion (SF) or nonselective fusion (NSF). The aim of the present investigation was to analyze the influence from different operative techniques on frontal curve correction and sagittal profile in patients with adolescent idiopathic scoliosis.
Methods: We conducted a retrospective analysis on 55 consecutive patients with scoliosis who had been treated by posterior instrumented fusion. We collected demographic data and analyzed pre- and postoperative radiographs. Statistical analysis was performed using SPSS version 25. Because data showed normal distribution, t tests were performed.
Results: Twenty-two patients were treated using the hybrid technique with screws and hooks; 25 were treated using the hybrid technique with screws, hooks, and tape; and 8 were treated using the all screws technique. An SF was performed in 32 patients and NSF in 23 patients. There was no significant difference with regard to curve correction of the main curve between the different techniques. Correction of the minor curve was significantly higher in NSF than in SF patients. In SF, there was a correction of the minor curve of 43.9%. Impact on sagittal balance showed no significant differences between NSF and SF.
Conclusion: The different operative techniques did not show a difference with regard to the correction of the main curve. NSF showed a significantly higher degree of correction of the minor curve than SF. However, we still found a correction of 43.9% of the noninstrumented minor curve in SF. Thus, SF and hybrid techniques do not lead to inferior radiographic outcome.
Clinical relevance: SF and hybrid techniques are safe and effective techniques that could be used as an alternative to NSF and all screw fixation in the operative treatment for scoliosis.
背景：通过后路手术矫正青少年特发性脊柱侧凸的方法有："全螺钉 "技术；螺钉和钩子混合技术；混合技术或螺钉、钩子和带子混合技术；选择性融合（SF）或非选择性融合（NSF）。本研究旨在分析不同手术技术对青少年特发性脊柱侧凸患者额曲线矫正和矢状面的影响：我们对55例连续接受后路器械融合术治疗的脊柱侧凸患者进行了回顾性分析。我们收集了人口统计学数据，并分析了术前和术后的X光片。统计分析使用 SPSS 25 版本进行。由于数据呈正态分布，因此进行了 t 检验：22例患者采用螺钉和挂钩混合技术进行治疗；25例患者采用螺钉、挂钩和胶带混合技术进行治疗；8例患者采用全螺钉技术进行治疗。32名患者接受了SF治疗，23名患者接受了NSF治疗。不同技术对主曲线的矫正效果没有明显差异。NSF 患者的小曲线矫正率明显高于 SF 患者。SF患者的小曲线矫正率为43.9%。NSF和SF对矢状平衡的影响无明显差异：结论：不同的手术技术在矫正主要曲线方面没有差异。NSF对小弯的矫正程度明显高于SF。然而，我们仍然发现，SF术中43.9%的非器械小曲线得到了矫正。因此，SF和混合技术并不会导致较差的影像学结果：SF和混合技术是安全有效的技术，可在脊柱侧凸的手术治疗中替代NSF和全螺钉固定：3:
期刊介绍：
The International Journal of Spine Surgery is the official scientific journal of ISASS, the International Intradiscal Therapy Society, the Pittsburgh Spine Summit, and the Büttner-Janz Spinefoundation, and is an official partner of the Southern Neurosurgical Society. The goal of the International Journal of Spine Surgery is to promote and disseminate online the most up-to-date scientific and clinical research into innovations in motion preservation and new spinal surgery technology, including basic science, biologics, and tissue engineering. The Journal is dedicated to educating spine surgeons worldwide by reporting on the scientific basis, indications, surgical techniques, complications, outcomes, and follow-up data for promising spinal procedures.
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