CAJ | 학술논문

目的:回顾分析TSRH、CD、Isola等第三代脊柱内固定系统在成人脊柱侧凸矫治中的应用并评价其疗效.方法:分析运用TSRH、CD、Isola脊柱内固定系统治疗的35例成人脊柱侧凸患者.术前冠状面主弯Cobb角平均58.1° (42°～95°),采用前后路联合矫形或单纯后路矫形手术方法.平均随访20个月(10～48个月).通过影像学资料对术前术后冠状面和矢状面的矫形效果对比分析并通过C7椎体中点距骶中线(CVSL)的距离来分析躯干平衡的重建,通过关于自我评估的问卷调查来获得患者主观治疗效果评价. 结果:所有患者术后外观矫形效果明显(P<0.05).总体冠状面主弯平均Cobb角矫正53.2%.末次随访冠状面Cobb角平均丢失4.3°.C7中点距CVSL由术前的平均2.6 cm矫正为术后的0.24 cm.通过随访期间的问卷调查89.3%以上的患者对外观改善、疼痛的缓解表示满意,2例术气胸、血胸,3例术后随访1年后仍主诉腰背部疼痛,其中2例为临近节段退变,1例为假关节形成. 结论:对于成人脊柱侧凸,第三代脊柱内固定系统能得到冠状面上较高的矫正率、重建躯干平衡,并且可以获得患者较高的满意度,并发症较少.
목적:회고분석TSRH、CD、Isola등제삼대척주내고정계통재성인척주측철교치중적응용병평개기료효.방법:분석운용TSRH、CD、Isola척주내고정계통치료적35례성인척주측철환자.술전관상면주만Cobb각평균58.1° (42°～95°),채용전후로연합교형혹단순후로교형수술방법.평균수방20개월(10～48개월).통과영상학자료대술전술후관상면화시상면적교형효과대비분석병통과C7추체중점거저중선(CVSL)적거리래분석구간평형적중건,통과관우자아평고적문권조사래획득환자주관치료효과평개. 결과:소유환자술후외관교형효과명현(P<0.05).총체관상면주만평균Cobb각교정53.2%.말차수방관상면Cobb각평균주실4.3°.C7중점거CVSL유술전적평균2.6 cm교정위술후적0.24 cm.통과수방기간적문권조사89.3%이상적환자대외관개선、동통적완해표시만의,2례술기흉、혈흉,3례술후수방1년후잉주소요배부동통,기중2례위림근절단퇴변,1례위가관절형성. 결론:대우성인척주측철,제삼대척주내고정계통능득도관상면상교고적교정솔、중건구간평형,병차가이획득환자교고적만의도,병발증교소.
Objective: To evaluate the efficacy of the third-generation instrumentation including TSRH, CD and ISOLA in the treatment of adult scoliosis. Methods:Thirty-five adult patients with idiopathic or degenerative scoliosis who received treatment with third-generation instrumentation (TSRH,CD and ISOLA) between July 1999 to January 2003 were retrospectively reviewed. The mean preoperative cobb angle of major curves of the frontal plane was 58.1°(42°-95°). The patients received a combined anteroposterior approach or a single posterior procedure. The mean follow-up time was 20 months(10-48 months). Preoperative and postoperative Cobb angles of the frontal plane and sagittal plane and the distance between C7 and CVLS were measured. The subjective assessment was judged by questionnaire. Results: Postoperative clinical appearance of all patients improved significantly. Mean correction of major curves of the coronal plane was 53.2%. Mean loss of correction of the coronal plane in the last follow-up was 4.3°. The distance between the midline of C7 and CVSL was corrected from 2.6 cm to 0.24 cm. The results of follow-up showed that 89.3% patients were satisfied with the outcome. Pneumatothorax and haematothorax occurred in 2 patients. Three patients still complained of low back pain one year after operation because of adjacent degeneration in 2 patients and pseudoarthrosis in the remaining 1 patient. Conclusion: Imageologic findings and subjective assessment of the patients showed that the third-generation instrumentation can achieve good correction and trunk balance in the treatment of adult scoliosis with fewer complications.