单向和多向胸椎椎弓根钉在青少年特发性脊柱侧凸矫形手术中的疗效分析

目的分析比较单向和多向椎弓根螺钉用于矫正青少年特发性脊柱侧凸的临床疗效。方法2001年2月～2004年9月，55名Lenkel型的青少年特发性脊柱侧凸患者用后路Mossmiami内固定系统进行矫形融合手术。其中30例应用单向钉，25例应用多向钉。所有患者随访时间超过2年，分别测量2组患者术前及术后上胸弯、主胸弯、胸腰弯Cobb角，肋骨椎体比以及肋骨分离距离等。结果平均融合椎体分别为7．9个（单向钉组）和7．2个（多向钉组）。2种方法都取得了良好的主胸弯的矫正效果，矫正率单向钉组为65．9％，多向钉组60％。单向钉用于矫正剃刀背畸形明显优于多向钉。2组患者都未出现明显的并发症。结论单向钉和多向钉对于主胸椎侧凸冠状位矫形都有良好的效果，但是单向钉比多向钉具有更好的去旋转以及恢复胸椎对称性的作用。

The clinical results of monaxial versus multiaxial thoracic pedicle screws in the correction of adolescent idiopathic scoliosis

Objective To evaluate the clinical results of monaxial versus multiaxial thoracic pedicle screws in the correction of adolescent idiopathic scoliosis(AIS).Methods Fifty-five patients with AIS,Lenke Type I,were treated by posterior correction and arthrodesis using Mossmiami instrumentation from February 2001 to September 2004.All the cases were randomly divided into 2 groups,30 of which were treated with monaxial pedicle screws and 25 were treated with multiaxial pedicle screws.The patients were followed up ...