COMPARISON BETWEEN PREOPERATIVE AND POSTOPERATIVE 3-DIMENSIONAL RECONSTRUCTIONS OF IDIOPATHIC SCOLIOSIS WITH THE COTREL-DUBOUSSET PROCEDURE
COMPARISON BETWEEN PREOPERATIVE AND POSTOPERATIVE 3-DIMENSIONAL RECONSTRUCTIONS OF IDIOPATHIC SCOLIOSIS WITH THE COTREL-DUBOUSSET PROCEDURE
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DOI：
10.1097/00007632-199512000-00005
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发表时间：
1995-12-01
期刊：
影响因子：
3
通讯作者：
DEGUISE, J
中科院分区：
文献类型：
--
作者：
LABELLE, H;DANSEREAU, J;DEGUISE, J
研究设计。对一组患有特发性脊柱侧弯的青少年进行术前和术后三维重建，并进行比较。目的。记录了 Cotrel-Dubousset 仪器和手术引起的胸椎和胸腔形状的变化。背景数据摘要。尽管许多作者报告了额状面的显着曲线改善，但记录脊柱去旋转的尝试仅显示对顶椎旋转的有限校正。方法。使用立体放射摄影技术对 37 名患有特发性脊柱侧凸的青少年进行术前和术后三维重建。使用学生 t 检验比较脊柱和胸腔的几个几何指数。结果。额状面的曲线矫正平均为 50%，最大曲率面的曲线矫正平均为 24%，而矢状面保持正常的胸椎后凸。最大曲率平面的方向明显向矢状面移动，表明胸椎的整体运动和畸形的三维矫正。发现椎体轴向旋转和肋骨驼峰发生了微小但显着的变化，并记录了肋骨整体方向的改善。结论。 Cotrel-Dubousset 器械和手术通过器械脊柱的整体重新定位而不是通过椎体轴向去旋转来有效地产生胸椎的三维改善。
Study Design. Pre- and postoperative three-dimensional reconstructions of the spine and rib cage were done and compared in a group of adolescents with idiopathic scoliosis.Objective. Changes in the shape of the thoracic spine and rib cage induced by the Cotrel-Dubousset instrumentation and procedure were documented.Summary of Background Data. Although many authors have reported significant curve improvement in the frontal plane, attempts to document derotation of the spine have shown only limited correction of apical vertebral rotation.Methods. Three-dimensional reconstructions were obtained pre- and postoperatively using a stereoradiographic technique in a group of 37 adolescents with idiopathic scoliosis. Several geometrical indices of the spine and rib cage were compared using Student t tests.Results. The curve correction averaged 50% in the frontal plane and 24% in the plane of maximum curvature, while normal thoracic kyphosis was maintained in the sagittal plane. The orientation of the plane of maximum curvature was shifted very significantly toward the sagittal plane, indicating en bloc movement of the thoracic spine and three-dimensional correction of the deformity. A small but significant change in vertebral axial rotation and rib hump was found and improvement in the overall orientation of the ribs was documented.Conclusions. The Cotrel-Dubousset instrumentation and procedure are effective in producing three-dimensional improvement of the thoracic spine by en bloc relocation of the instrumented spine rather than by vertebral axial derotation.