手术治疗神经肌肉性脊柱侧凸患者有无术中牵引的分析

Q4 Medicine Coluna/ Columna Pub Date : 2022-01-01 DOI:10.1590/s1808-185120222103262614
B. Nunes, D. Zanotto, Christiano Cruz Lima, Germano Senna, L. T. P. E. Silva, J. Nascimento, C. Reis, Bruno Pinto Coelho Fontes
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摘要

目的:比较术中颅骨-骨骼牵引(ISST)与不术中颅骨牵引(ISST)治疗神经肌肉性脊柱侧凸(NMS)在曲线矫正程度、手术时间、住院时间、螺钉密度、血液制品使用和并发症等方面的差异。方法:回顾性比较分析17例手术治疗神经肌肉性脊柱侧凸(NMS)患者的病历和影像学资料。他们被分为两组,分别有9名和8名患者于2019年至2021年在一家专门治疗脊柱畸形的转诊医院接受了ISST手术和非ISST手术。分类变量采用卡方检验进行分析。结果:纳入研究的17例患者中,无ISST组(6岁和2岁)女性患病率较高,有ISST组(5岁和3岁)男性患病率较高。两组患者年龄分别为8-19岁和11-29岁。牵引组螺钉密度平均为66.33%±8.49,非牵引组为82.63%±17.25,p值为0.036,差异有统计学意义。牵引组的平均矫正率为76.81%±15.61,而非牵引组的平均矫正率为66.39%±12.99。此外,两组各有1例患者出现并发症。结论:手术治疗伴有ISST的NMS允许手术使用较少的血液制品来维持术后相同的血清学水平。ISST也允许使用较低的螺钉密度来矫正更严重的畸形。证据等级III;比较回顾性研究。
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ANALYSIS OF PATIENTS SUBMITTED TO SURGICAL TREATMENT FOR NEUROMUSCULAR SCOLIOSIS WITH AND WITHOUT INTRAOPERATIVE TRACTION
ABSTRACT Objectives: To compare the surgical treatment of neuromuscular scoliosis (NMS) with and without intraoperative skull-skeletal traction (ISST) in terms of the degree of curve correction, surgical time, hospitalization time, screw density, use of blood products,and complications. Methods: A comparative retrospective study, in which we analyzed the medical records and radiographs of 17 patients who underwent surgical treatment for neuromuscular scoliosis (NMS). They were divided into two groups, with 9 and 8 patients operated with and without ISST, respectively, at a referral hospital specialized in the treatment of spinal deformitiesfrom 2019 to 2021. The categorical variables were analyzed using the Chi-squared test. Results: Among the 17 patients included in the study, there was a higher prevalence of women in the group without ISST (6 and 2) and of men in group with ISST (5 and 3). The ages of the patients in the two groups ranged from 8-19 years and from 11-29 years, respectively. The screw density used in the traction group averaged 66.33%±8.49 and 82.63%±17.25 in the non-traction group, a statistically significant differencewith a P-value of 0.036. The average percent correction was 76.81%±15.61 in the traction group as compared to an average of 66.39%±12.99 in the non-traction group. In addition, there were complications in 1 patient in each of the groups. Conclusions: Surgical treatment for NMS with ISST allows surgery using fewer blood products to maintain the same hematimetric level in the postoperative period. ISST also allows the use of a lower screw density to correct more severe deformities. Level of evidence III; Comparative retrospective study.
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来源期刊
Coluna/ Columna
Coluna/ Columna Medicine-Surgery
CiteScore
0.40
自引率
0.00%
发文量
32
审稿时长
10 weeks
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