全椎弓根螺钉与钩钉联合系统对脊柱侧凸的矫形效果比较

目的比较全椎弓根螺钉与钩钉联合系统对特发性脊柱侧凸的后路矫形效果。方法对40例特发性脊柱侧凸患者进行回顾性对照研究,其中全节段椎弓根螺钉组20例,钩钉联合器械组20例。对两组的手术效果、手术时间和失血量等进行对照分析。结果平均冠状面矫形率：全节段椎弓根螺钉组82．4％,钩钉联合器械组71．8％（P〈0．01）;术后1—3年平均冠状面矫形率：全节段椎弓根螺钉组77．O％,钩钉联合器械组62．5％（P〈0．01）;平均顶椎旋转矫正率：全节段椎弓根螺钉组63％,钩钉联合器械组32％（P〈0．01）。而矢状面矫形效果、下固定椎倾斜度改善率、躯干偏移、手术时间、失血量方面,两组无明显差别（P〉0．05）。所有病例均未出现脊髓、神经根损伤等严重并发症。结论全椎弓根螺钉较钩钉联合系统具有更好的矫形效果,胸椎椎弓根螺钉置入安全可靠。

Comparative analysis of pedicle screw versus hybrid instrumentation in posterior spinal correction of adolescent idiopathic scoliosis

OBJECTIVE: To compare the effect of posterior correction and fusion between segmental pedicle screw instrumentation with hybrid constructs in adolescent idiopathic scoliosis (AIS). METHODS: Study the clinical data of 40 AIS patients retrospectively. They were underwent posterior fusion and be distributed into two group, group A was hybrid instrumentation (20 cases) and group B was pedicle screw instrumentation (20 cases). Compared therapy effection, operative time, intraoperative blood loss. RESULTS: The average major curve correction was 82.4% in the screw group and 71.8% in the hybrid group (P = 0.004). Altere one to three years follow-up, major curve correction was 77.0% and 62.5% respectively (P = 0.001). Average apical vertebral derotation showed 63% correction in the screw group and 32% in the hybrid group (P = 0.001). There was no statistical significance between two group in thoracic sagittal correction, the lowest instrumented vertebra below the lower end vertebra, trunk shift, operative time, and average estimated blood loss. There were no neurologic complications related to hybrid or pedicle screw instrumentation. CONCLUSION: Pedicle screw instrumentation was significantly better than hybrid constructs.