张伟;朱晓东;吴大江;易红蕾;陈家瑜;吴冰;魏显招;张涤清;李明;

• 1:第二军医大学长海医院骨科

摘要(Abstract)：

[目的]回顾性分析全椎弓根螺钉矫形治疗Lenke 1型青少年特发性脊柱侧凸矫正率与置钉密度间的相关性。[方法]2007~2009年,56例行后路全椎弓根螺钉矫形内固定的Lenke 1型青少年特发性脊柱侧凸患者纳入回顾性研究。测量术前、术后影像学资料,分析侧凸矫正率与置钉密度的相关性。[结果]所有患者无手术相关的严重并发症发生。主胸弯角度由术前平均53.4°±11.7°矫正为18.4°±10.5°(P<0.05),冠状面平均矫正率为66.8%。胸椎后凸由术前31.8°±4.39°降至22.3°±3.13°(P<0.05)。平均置钉密度为1.56(1.0~2.0)。矢状面胸椎后凸的减小与冠状面Cobb角的矫正度数和矫正率明显相关(P<0.05)。置钉密度与侧凸矫正率无相关性。[结论]椎弓根螺钉系统治疗胸椎特发性侧凸可以获得良好的冠状面矫形,但会造成矢状面胸椎后凸减小。置钉密度与侧凸的矫正率无相关性。

关键词(KeyWords)： 青少年特发性脊柱侧凸;椎弓根钉;矫正率;置钉密度

Abstract:

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作者(Author): 张伟;朱晓东;吴大江;易红蕾;陈家瑜;吴冰;魏显招;张涤清;李明;

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参考文献(References)：

• [1]Kim YJ,Lenke LG,Bridwell KH,et al.Free hand pedicle screw place-ment in the thoracic spine:is it safe[J].Spine,2004,3:333-342.
• [2]Kuklo TR,Potter BK,Polly DW,et al.Monaxial versus multiaxial thoracicpedicle screws in the correction of adolescent idiopathic scoliosis[J].Spine,2005,18:2113-2120.
• [3]Luk KD,Lu DS,Cheung KM,et al.A prospective comparison of the coro-nal deformity correction in thoracic scoliosis using four different instru-mentations and the fulcrum-bending radiograph[J].Spine,2004,5:560-563.
• [4]Suk SI,KimWJ,KimJH,et al.Restoration of thoracic kyphosis in the hy-pokyphotic spine:a comparison between multiple-hook and segmentalpedicle screw fixation in adolescent idiopathic scoliosis[J].J Spinal Dis-ord,1999,6:489-495.
• [5]Lowenstein JE,Matsumoto H,Vitale MG,et al.Coronal and sagittal planecorrection in adolescent idiopathic scoliosis:a comparison between allpedicle screw versus hybrid thoracic hook lumbar screw constructs[J].Spine,2007,4:448-452.
• [6]Vora V,Crawford A,Babekhir N,et al.Apedicle screwconstruct gives anenhanced posterior correction of adolescent idiopathic scoliosis when com-pared with other constructs:myth or reality[J].Spine,2007,17:1869-1774.
• [7]Lehman RA,Lenke LG,Keeler KA,et al.Operative treatment of adoles-cent scoliosis with posterior pedicle screw-only constructs:minimumthree-year follow-up of one hundred fourteen cases[J].Spine,2008,14:1598-1604.
• [8]Rhee JM,Bridwell KH,Won DS,et al.Sagittal plane analysis of adoles-cent idiopathic scoliosis:the effect of anterior versus posterior instrumen-tation[J].Spine,2002,21:2350-2356.
• [9]Sucato DJ,Agrawal S,O’Brien MF,et al.Restoration of thoracic kyphosisafter operative treatment of adolescent idiopathic scoliosis:a multicentercomparison of three surgical approaches[J].Spine,2008,24:2630-2636.
• [10]Mulpuri K,Perdios A,Reilly CW.Evidence-based medicine analysis ofall pedicle screwconstructs in adolescent idiopathic scoliosis[J].Spine,2007,19:109-114.
• [11]D’Andrea LP,Betz RR,Lenke LG,et al.Do radiographic parameterscorrelate with clinical outcomes in adolescent idiopathic scoliosis[J].Spine,2000,14:1795-1802.
• [12]Lenke LG,Kuklo TR,Ondra S,et al.Rationale behind the current state-of-the-art treatment of scoliosis(in the pedicle screw era)[J].Spine,2008,10:1051-1054.