脊柱侧弯内固定系统置入及三维重建技术的应用

Scoliosis fixation system implantation and the application of three-dimensional reconstruction technique

BACKGROUND: Scoliosis is a complex three-dimensional plane deformity, including lateral bending on the coronal plane, before physiological kyphosis reduction or increase in the sagittal plane, the rotational deformity of the spine in the axial plane. The method of full decompression, maximum reconstruction of spinal balance in coronal and sagittal plane, long-segmental fixation and short-segmental fusion is the more ideal orthopedic method for degenerative scoliosis. OBJECTIVE: To analyze the characteristics of scoliosis fixation system. METHODS: The articles about scoliosis fixation system were retrieved from PubMed database, Chinese Journal Full-text database from 1999 to 2015 by the first author using computer. “Scoliosis, Internal Fixation, Three-dimensional Correction” were taken as the search terms in English and Chinese. Totally 163 relevant articles were retrieved, and eventually 34 articles met the inclusion criteria. RESULTS AND CONCLUSION: With the development of fixation materials, the spinal fixation system which was designed based on three-dimensional orthopedic concept of spine is a dynamically developed system. The goal is to restore the balance of spine in three dimensions as comprehensive as possible. At present, the general spinal system within very broad application includes TSRH spinal fixation system, ISOLA spinal internal fixation system, Moss Miami spinal fixation system, CD Horizon spinal internal system and China Great Wall spinal fixation system. Spinal fixation system possesses three-dimensional orthopedic capability, and can correct the spinal deformity in coronal and sagittal plane, and biomechanics is reasonable, fixed and reliable. Bone grafting material is the key factor of preventing breakage of internal fixation, screw extraction and other complications. Compared with such bone grafting materials made of autologous bone, allograft bone and xenograft bone, artificial bone can shorten the orthopedic time and reduce the risk of concurrent diseases because of bone grafting, which is the future trend of bone grafting material. Meanwhile, three-dimensional reconstruction has been used in clinical practice, and can develop programs for scoliosis orthopedic treatment, provide imaging reference to ensure the security of internal fixation and also has played a huge role in improving the comprehensive efficacy of spinal internal fixation system.