连续置钉或间隔置钉矫治LenkeⅠ型青少年特发性脊柱侧凸的效果  

Comparision of interval and consecutive pedicle screw placement for Lenke 1 adolescent idiopathic scoliosis

作　　者：方秀统[1,2] 李明[3] 赵颍川[3] 谢阳[3] 陶凤华[3] 王传峰[3] 沈煜[4] 

机构地区：[1]北京大学第九临床医院 [2]北京世纪坛医院骨科,北京市100038 [3]第二军医大学附属长海医院骨科,上海市200433 [4]北京宣武医院血管外科,北京市100053

出　　处：《中国脊柱脊髓杂志》2010年第5期367-370,共4页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:对比后路间隔置钉或连续置钉矫治LenkeⅠ型青少年特发性脊柱侧凸的效果。方法:将2004年1月～2006年6月期间收治的32例LenkeⅠ型青少年特发性脊柱侧凸患者随机分成两组,一组手术方法为后路矫形侧连续置入椎弓根螺钉进行矫形(连续置钉组);另一组手术方法为后路矫形侧均间隔一个椎体置入椎弓根螺钉进行矫形(间隔置钉组)。记录所有患者冠状面和矢状面的术前侧凸Cobb角、术后侧凸Cobb角、术后侧凸矫正率并进行两组间比较分析。结果:两组患者术中均无神经脊髓损伤。胸椎侧凸冠状面、矢状面Cobb角连续置钉组术前分别为62.7°±12.7°、28.3°±11.6°;术后分别为14.5°±6.9°、20.5°±10.7°;间隔置钉组术前分别为63.9°±10.9°、28.1°±10.8°,术后分别为14.7°±6.4°、21.0°±10.3°;连续置钉组和间隔置钉组术前C7铅垂线与S1椎体后缘的距离分别为-3.3±6.1cm、-4.4±4.8cm,术后分别为1.4±3.3cm、0.9±3.0cm。两组患者术前及术后冠状面、矢状面侧凸Cobb角及C7铅垂线与S1椎体后缘距离无统计学差异(P>0.05)。结论:间隔置钉和连续置钉矫正LenkeⅠ型青少年特发性脊柱侧凸效果相比较无统计学差异。Objective：To compare the clinical efficacy of the interval and consecutive pedicle screw placement for Lenke 1 adolescent idiopathic scoliosis（AIS）.Method：Thirty-two patients with Lenke 1 AIS were randomly divided into two groups.In group 1,posterior fusion was performed using consecutive pedicle screw placement on the correction side,and in group 2,interval pedicle screw placement was performed on the correction side.The following variables including pre-and post-operative sagittal and coronal Cobb angle and sciliosis correction rate were observed.Result：No neurologic deficit related to surgery was presented in both groups.Cobb angle of major curve decreased significantly from 62.7°±12.7° of preoperative to 14.5°±6.8° of postoperative and from 63.9°±10.9°of preoperative to 14.7°±6.4° of postoperative for the consecutive and interval pedicle screw placement group respectively.Thoracic sagittal Cobb angle decreased significantly from 28.3° ±11.6° of preoperative to 20.5°±10.7° of postoperative and from 28.1°±10.8° of preoperative to 21.0°±10.3° of postoperative for the consecutive and interval pedicle screw placement group respectively.Global sagittal imbalance decreased significantly from-3.3±6.1cm of preoperative to 1.4±3.3cm of postoperative and from-4.4± 4.8cm of preoperative to 0.9±3.0cm of postoperative for the consecutive and interval group respectively.There were no differences between two groups with respect to any postoperative parameters.Conclusion：Either interval or consecutive pedicle screw placement has equal correction effect for Lenke 1 AIS.

关 键 词：青少年特发性脊柱 LenkeⅠ型 连续置入椎弓根螺钉 间隔置入椎弓根螺钉 

分 类 号：R682.3[医药卫生—骨科学] R687.3[医药卫生—外科学]