Comparison of novel ultra-high molecular weight polyethylene tape versus conventional metal wire for sublaminar segmental fixation in the treatment of adolescent idiopathic scoliosis
Comparison of novel ultra-high molecular weight polyethylene tape versus conventional metal wire for sublaminar segmental fixation in the treatment of adolescent idiopathic scoliosis
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DOI：
10.1097/bsd.0b013e318030d30e
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发表时间：
2007-08-01
影响因子：
--
通讯作者：
Minami, Akio
中科院分区：
文献类型：
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作者：
Takahata, Masahiko;Ito, Manabu;Minami, Akio
研究设计：回顾性研究。目的：比较椎板下Nesplon带或椎板下金属丝混合器械系统治疗青少年特发性脊柱侧凸（AIS）的手术效果。背景资料概述：Nesplon胶带由一根超高分子量聚乙烯纤维线组成，与金属丝相比具有以下优点：(1)其柔软和柔韧的特性避免了神经损伤；(2)其平坦的结构避免了应力集中分布在层板上；然而，Nesplon胶带在脊柱畸形矫正中的疗效至今仍不清楚。方法：同一机构的30例AIS患者使用混合器械进行后路矫正和融合，包括钩、椎弓根螺钉、椎板下聚乙烯胶带（15）或椎板下金属钢丝（15）。根据曲线矫正、手术时间、术中出血量、并发症的影像学变化以及脊柱侧凸研究协会患者问卷（SRS-24）评分对患者进行术前、术后和2年随访。结果：Nesplon胶带组术后即刻矫正率为63.0%，金属丝组术后即刻矫正率为59.9% （P = 0.62）。两组患者均获得融合，无明显矫正损失。两组患者手术时间、术中出血量、术后SRS-24评分差异无统计学意义。Nesplon胶带组1例患者出现浅表皮肤感染，1例患者出现一过性感觉障碍，金属丝组1例患者出现颞上肠系膜动脉综合征。结论：Nesplon胶带矫正畸形的效果与金属丝相当，融合完成且无明显矫正损失。Nesplon胶带柔软柔韧的特性和平坦的结构使其成为治疗骨易碎性AIS或包含脊髓的融合区域的安全应用。
Study Design: Retrospective study. Objectives: To compare the surgical outcomes of posterior translational correction and fusion using hybrid instrumentation systems with either sublaminar Nesplon tape or sublaminar metal wire to treat adolescent idiopathic scoliosis (AIS). Summary of Background Data: Nesplon tape, which consists of a thread of ultra-high molecular weight polyethylene fibers, has advantages over metal wire: (1) its soft and flexible properties avoid neural damage and (2) its flat configuration avoids focal distribution of the stresses to lamina; however, the efficacy of Nesplon tape in the correction of spinal deformity is as yet, still unclear. Methods: Thirty AIS patients at a single institution underwent posterior correction and fusion using hybrid instrumentation containing hook, pedicle screw, and either sublaminar polyethylene taping (15) or sublaminar metal wiring (15). Patients were evaluated preoperatively, immediately after surgery, and at a 2-year follow-up according to the radiographic changes in curve correction, operating time, intraoperative blood loss, complications, and the Scoliosis Research Society patient questionnaire (SRS-24) score. Results: The average correction rate was 63.0% in the Nesplon tape group and 59.9% in the metal wire group immediately after surgery (P = 0.62). Fusion was obtained in all the patients without significant correction loss in both groups. There was no significant difference in operative time, intraoperative blood loss, and postoperative SRS-24 scores between the 2 groups. Complications were superficial skin infection in a single patient in the Nesplon tape group, and transient sensory disturbance in I patient and temporal superior mesenteric artery syndrome in another patient in the metal wire group. Conclusions: The efficacy of Nesplon tape in correction of deformity is equivalent to that of metal wire, and fusion was completed without significant correction loss. The soft and flexible properties and flat configuration of Nesplon tape make this a safe application for the treatment of AIS with bone fragility or with the fusion areas containing the spinal cord.