Isola内固定系统治疗特发性脊柱侧凸椎板下钢丝的安全性

目的评价椎板下钢丝技术在特发性脊柱侧凸手术中的安全性。方法本组14例患者，平均年龄为14．5岁(9-21)岁。患者术前诊断均为青少年特发性脊柱侧凸，且均为首次手术。本文对所有患者的侧凸类型、严重程度、固定椎体的数量、钢丝固定的椎体水平、术后神经学并发症以及术中脊髓监测的变化进行了详细评估。所有患者的椎板下钢丝均在矫正操作之前进行。结果总计放置了76根钢丝，75％(n=57)位于胸椎，20％(n=15)位于胸腰段，5％(n=4)位于腰椎。术中脊髓监测未发现明显的改变。所有患者均成功进行了唤醒试验。在青少年特发性脊柱侧凸患者中未发现有神经学并发症。结论尽管脊柱内固定系统越来越复杂，椎板下穿钢丝的技术在无神经症状的特发性脊柱侧凸患者的手术治疗中还是安全有效的辅助技术。

Safety of sublaminar wires with Isola instrumentation for idiopathic scoliosis

Objective To assess the safety of sublaminar wires in the surgical treatment of idiopathic scoliosis. Methods Preoperative diagnosis was adolescent idiopathic scoliosis in 14 cases with an average age of 14.5 years (range 9-21 years), who all got the primary operations. Detailed evaluations of the curvature types, curvature levels, the numbers of fixated vertebraes, the levels of vertebraes fixated by wires, postoperative neurological complications and the findings of intraoperative spinal cord monitoring were performed. Sublaminar wires were performed just before corrective operation. Results A total of 76 wires were placed, 75% (n= 57) in the thoracic region, 20% (n= 15) in the thoracolumbar, and 5% (n= 4) in the lumbar. No significant change was found by intraoperative spinal cord monitoring. Awaken test was performed successfully in all cases. No neurological complication happened. Conclusion Despite the increasing complexity of spinal instrumentation systems, the placement of sublaminar wire is a safe and effective complement technique in the surgical treatment of idiopathic scoliosis without neurological symptoms.