悬臂法治疗胸腰椎结核性脊柱炎后凸复位的疗效:短期随访。

IF 1.7 Q2 ORTHOPEDICS Orthopedic Research and Reviews Pub Date : 2021-12-03 eCollection Date: 2021-01-01 DOI:10.2147/ORR.S342365
Didik Librianto, Ismail Hadisoebroto Dilogo, Achmad Fauzi Kamal, Ifran Saleh, Fachrisal Ipang, Dina Aprilya
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引用次数: 0

摘要

背景:结核性脊柱炎(STb)后凸症不仅仅是一个美容问题。它对脊柱相关结构和心肺功能都有潜在的有害影响。可以在STb的任何阶段进行校正;然而,矫正手术是具有挑战性的,特别是在后期的情况下,其中额外的脊柱僵硬可以考虑。迄今为止,悬臂技术仍然是矢状面畸形矫正的金标准。然而,迄今为止还没有研究探讨其对胸腰椎后凸畸形的有效性,特别是由脊柱炎结核引起的后凸畸形。方法:回顾性分析2020-2021年在我中心连续行矫形手术的16例结核性脊柱炎合并胸腰椎后凸。我们的目的是评估悬臂技术用于胸腰椎STb患者后凸矫正的有效性。结果:随访3个月时,平均Cobb角为14.6°±10.27°,平均增益为20.90°±12.00°,与胸腰椎后凸(TLK)矫正量呈正相关(68.69%,r = 0.654, p = 0.001)。胸椎后凸、腰椎前凸、矢状椎轴平均分别为30.6°±13.08°、39.4°±16.02°、1.4±4.09 cm,矢状Cobb差为12.70±9.85。结论:胸腰段悬臂式Cobb角复位术能明显改善胸腰段后凸,使脊柱矢状轴复位。因此,悬臂技术仍然是矢状面畸形矫正的金标准,可以应用于胸腰椎STb病例的后凸畸形矫正。
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Effectiveness of Kyphosis Reduction Using Cantilever Method in Thoracolumbar Spondylitis Tuberculosis: A Short-Term Follow-Up.

Background: Kyphosis in spondylitis tuberculosis (STb) is more than just a cosmetic issue. It has a potentially detrimental effect on both spine-associated structures and cardiopulmonary function. It can be corrected in any stage of STb; however, the corrective surgery is challenging, especially in the late case, in which the additional stiffness of the spine can come into consideration. To date, the cantilever technique is still a gold standard for sagittal plane deformity correction. However, no study to date has explored its effectiveness for thoracolumbar kyphotic deformity, especially that caused by spondylitis tuberculosis.

Methods: This is a retrospective study of 16 consecutive cases of spondylitis tuberculosis with thoracolumbar kyphosis that underwent corrective surgery in our center in the period of 2020-2021. We aim to evaluate the effectiveness of the cantilever technique that we use for kyphotic correction in thoracolumbar STb patients.

Results: At the 3-months follow-up, the mean Cobb angle was 14.6°±10.27°, with the mean gain of 20.90°±12.00° and positively correlate with the thoracolumbar kyphosis (TLK) correction (68.69%, r = 0.654, p = 0.001). The mean thoracic kyphosis, lumbar lordosis, and sagittal vertebral axis were 30.6°±13.08°, 39.4°±16.02°, and 1.4±4.09 cm, respectively, with sagittal Cobb difference of 12.70±9.85.

Conclusion: The kyphotic Cobb angle reduction by cantilever technique in the thoracolumbar area significantly improved the thoracolumbar kyphosis and realign the spinal sagittal axis. Thus, the cantilever technique remains the gold standard for sagittal plane deformity correction which can be applied for kyphotic deformity correction in thoracolumbar STb cases.

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来源期刊
Orthopedic Research and Reviews
Orthopedic Research and Reviews Medicine-Orthopedics and Sports Medicine
CiteScore
2.80
自引率
0.00%
发文量
51
审稿时长
16 weeks
期刊介绍: Orthopedic Research and Reviews is an international, peer-reviewed, open-access journal focusing on the patho-physiology of the musculoskeletal system, trauma, surgery and other corrective interventions to restore mobility and function. Advances in new technologies, materials, techniques and pharmacological agents will be particularly welcome. Specific topics covered in the journal include: Patho-physiology and bioengineering, Technologies and materials science, Surgical techniques, including robotics, Trauma management and care, Treatment including pharmacological and non-pharmacological, Rehabilitation and Multidisciplinarian care approaches, Patient quality of life, satisfaction and preference, Health economic evaluations. The journal welcomes submitted papers covering original research, basic science and technology, clinical studies, reviews and evaluations, guidelines, expert opinion and commentary, case reports and extended reports.
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