Objective To analyze the influence of segmental pedicle screws versus hybrid instrumentation on the correction results in adolescent idiopathic scoliosis patients undergoing posterior selective thoracic fusion. Metho...Objective To analyze the influence of segmental pedicle screws versus hybrid instrumentation on the correction results in adolescent idiopathic scoliosis patients undergoing posterior selective thoracic fusion. Methods By reviewing the medical records and roentgenograms of adolescent idiopathic scoliosis patients who underwent selective thoracic fusion from February 2000 to January 2007 in our hospital, the patients were divided into 2 groups according to different instrumentation fashions： Group A was hook-screw-rod （hybrid） internal fixation type, Group B was screw-rod （all pedicle screws） internal fixation type, and the screws were used in every segment on the concave side of the thoracic curve. The parameters of the scoliosis were measured and the correction results were analyzed. Results Totally, 48 patients （7 males, 41 females） were included, with an average age of 14.4 years old and a mean follow-up time of 12.3 months. Thirty and 18 patients were assigned to group A and group B, respectively. The mean preoperative coronal Cobb angles of the thoracic curve were 48.8° and 47.4°, respectively. After surgery, they were corrected to 13.7° and 6.8°, respectively. At final follow-up, they were 17.0° and 9.5°, with an average correction rate of 64.6% and 79.0%, respectively, and the correction rate of group B was significantly higher than that of group A （P=0.003）. The mean preoperative coronal Cobb angles of the lumbar curve were 32.6° and 35.2°, respectively. After surgery, they were corrected to 8.6° and 8.3°, respectively. At final follow-up, they were 10.3° and 11.1°, with an average correction rate of 66.8% and 69.9%, respectively, and the correction rate of group B was significantly higher than that of group A （P=0.003）. The correction loss of the thoracic curve and lumbar curve in the 2 groups were 3.1° and 1.8°, 2.4° and 2.4°, respectively. No significant difference was noted （both P〉0.05）. The decompensation rate at final follow-up in these 2 groups were 4%展开更多
目的对比2种后路短节段固定方式治疗胸腰段骨折的疗效.方法郑州市第一人民医院收治胸腰段MagerlA型骨折37例,依据就诊顺序分为对照组和治疗组,对照组19例,采取短节段经伤椎椎弓根钉技术（伤椎以及伤椎上下各1椎体各植入2枚椎弓根钉）,...目的对比2种后路短节段固定方式治疗胸腰段骨折的疗效.方法郑州市第一人民医院收治胸腰段MagerlA型骨折37例,依据就诊顺序分为对照组和治疗组,对照组19例,采取短节段经伤椎椎弓根钉技术（伤椎以及伤椎上下各1椎体各植入2枚椎弓根钉）,治疗组18例,采取后路微＂八＂式跨伤椎椎弓根钉植入短节段固定技术,对比2种术式术前、术后、随访期（12~14个月）椎体前缘高度百分比（AVH%）、椎体后缘高度百分比（PVH%）、矢状面指数（sagittal index,SI）及矫正率,以及日本骨科协会评估治疗分数（japanese orthopedic association scores,JOA）功能评分及改善率、内固定失效率等,评价2种术式临床疗效.结果治疗组AVH%矫正率高于对照组（P〈0.05）,PVH%、SI、内固定失效率比较差异无统计学意义（P〉0.05）.JOA评分改善率治疗组优于对照组（P〈0.05）,随访期JOA评分改善率组间比较差异无统计学意义（P〉0.05）.对照组手术时间明显长于治疗组,出血量也高于治疗组,差异有统计学意义（P〈0.05）,2组患者术后住院时间比较差异无统计学意义（P〉0.05）.结论后路微＂八＂式跨伤椎椎弓根钉植入短节段固定技术是治疗胸腰段骨折有效方法,具有良好的生物力学特性.展开更多
文摘Objective To analyze the influence of segmental pedicle screws versus hybrid instrumentation on the correction results in adolescent idiopathic scoliosis patients undergoing posterior selective thoracic fusion. Methods By reviewing the medical records and roentgenograms of adolescent idiopathic scoliosis patients who underwent selective thoracic fusion from February 2000 to January 2007 in our hospital, the patients were divided into 2 groups according to different instrumentation fashions： Group A was hook-screw-rod （hybrid） internal fixation type, Group B was screw-rod （all pedicle screws） internal fixation type, and the screws were used in every segment on the concave side of the thoracic curve. The parameters of the scoliosis were measured and the correction results were analyzed. Results Totally, 48 patients （7 males, 41 females） were included, with an average age of 14.4 years old and a mean follow-up time of 12.3 months. Thirty and 18 patients were assigned to group A and group B, respectively. The mean preoperative coronal Cobb angles of the thoracic curve were 48.8° and 47.4°, respectively. After surgery, they were corrected to 13.7° and 6.8°, respectively. At final follow-up, they were 17.0° and 9.5°, with an average correction rate of 64.6% and 79.0%, respectively, and the correction rate of group B was significantly higher than that of group A （P=0.003）. The mean preoperative coronal Cobb angles of the lumbar curve were 32.6° and 35.2°, respectively. After surgery, they were corrected to 8.6° and 8.3°, respectively. At final follow-up, they were 10.3° and 11.1°, with an average correction rate of 66.8% and 69.9%, respectively, and the correction rate of group B was significantly higher than that of group A （P=0.003）. The correction loss of the thoracic curve and lumbar curve in the 2 groups were 3.1° and 1.8°, 2.4° and 2.4°, respectively. No significant difference was noted （both P〉0.05）. The decompensation rate at final follow-up in these 2 groups were 4%
文摘目的对比2种后路短节段固定方式治疗胸腰段骨折的疗效.方法郑州市第一人民医院收治胸腰段MagerlA型骨折37例,依据就诊顺序分为对照组和治疗组,对照组19例,采取短节段经伤椎椎弓根钉技术（伤椎以及伤椎上下各1椎体各植入2枚椎弓根钉）,治疗组18例,采取后路微＂八＂式跨伤椎椎弓根钉植入短节段固定技术,对比2种术式术前、术后、随访期（12~14个月）椎体前缘高度百分比（AVH%）、椎体后缘高度百分比（PVH%）、矢状面指数（sagittal index,SI）及矫正率,以及日本骨科协会评估治疗分数（japanese orthopedic association scores,JOA）功能评分及改善率、内固定失效率等,评价2种术式临床疗效.结果治疗组AVH%矫正率高于对照组（P〈0.05）,PVH%、SI、内固定失效率比较差异无统计学意义（P〉0.05）.JOA评分改善率治疗组优于对照组（P〈0.05）,随访期JOA评分改善率组间比较差异无统计学意义（P〉0.05）.对照组手术时间明显长于治疗组,出血量也高于治疗组,差异有统计学意义（P〈0.05）,2组患者术后住院时间比较差异无统计学意义（P〉0.05）.结论后路微＂八＂式跨伤椎椎弓根钉植入短节段固定技术是治疗胸腰段骨折有效方法,具有良好的生物力学特性.
