Anson G Bautista, Justin L Reyes, Nathan J Lee, Michael W Fields, Zeeshan M Sardar, Lawrence G Lenke, Joseph M Lombardi, Ronald A Lehman
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引用次数: 0
Abstract
Spinal deformity surgery often requires complex surgical interventions that can have a drastic effect on both patient quality of life and functional capacity. Modern-day corrective solutions for these deformities include spinal osteotomies, pedicle screw instrumentation, and dual/multirod constructs. These solutions are efficacious and are currently considered standard practice for spinal surgeons, but they lack individualization. Patient-specific rods (PSRs) are a novel technology that attempts to offer a personalized approach to spinal deformity correction based on preoperative computerized tomography scans. Moreover, PSRs may offer several advantages to conventional rods, which include achievement of desired rod contour angles according to surgical planning alignment goals, reduced operative time, and reduced blood loss. In adolescent idiopathic scoliosis, those instrumented with PSR have observed coronal Cobb reductions up to 74%. In adult spinal deformity, PSRs have offered superior correction in radiographic parameters such as sagittal vertical axis and pelvic incidence minus lumbar lordosis. However, there still remains a paucity of research in this area, mainly in health care expenditure, cost-effectiveness, and longitudinal clinical outcomes. The purpose of this article is to survey the current body of knowledge of PSR instrumentation in both adolescent and adult spinal deformity populations. The current strength, limitations, and future directions of PSRs are highlighted throughout this article.
脊柱畸形手术通常需要复杂的手术干预,这会对患者的生活质量和功能能力产生巨大影响。针对这些畸形的现代矫正方案包括脊柱截骨术、椎弓根螺钉器械植入术和双/多螺柱结构。这些方案都很有效,目前被认为是脊柱外科医生的标准做法,但它们缺乏个性化。患者特异性矫正杆(PSR)是一种新型技术,它试图根据术前计算机断层扫描提供个性化的脊柱畸形矫正方法。此外,与传统矫形棒相比,PSRs 还具有一些优势,包括根据手术规划对齐目标实现所需的矫形棒轮廓角度、缩短手术时间和减少失血量。在青少年特发性脊柱侧凸中,使用 PSR 的患者的冠状面 Cobb 降低率高达 74%。在成人脊柱畸形中,PSR 在矢状垂直轴和骨盆内陷减去腰椎前凸等影像学参数方面具有卓越的矫正效果。然而,这方面的研究仍然很少,主要是在医疗支出、成本效益和纵向临床结果方面。本文旨在对青少年和成人脊柱畸形人群中 PSR 器械的现有知识体系进行调查。本文重点介绍了 PSR 目前的优势、局限性和未来发展方向。
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.