NEW UNIVERSAL INSTRUMENTATION IN SPINAL SURGERY
NEW UNIVERSAL INSTRUMENTATION IN SPINAL SURGERY
复制标题
脊柱外科的新型通用器械
DOI：
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发表时间：
1988
影响因子：
4.2
通讯作者：
M. Guillaumat
中科院分区：
文献类型：
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作者：
Y. Cotrel;J. Dubousset;M. Guillaumat
一种用于后路脊柱手术的新型器械由刻有菱形凸体的金属棒组成，其上可以在任何位置、水平或旋转角度拧入椎骨钩或螺钉。通过横向牵引装置（DTT）将棒互锁，该装置为矩形结构，带有多个椎骨夹具，其稳定性允许抑制任何术后外部支撑。最初设计用于治疗脊柱侧凸，这种器械设计允许位于曲线顶点的椎骨活动并获得三维矫正。最重要的结构变形的区域的矫正也可以在端椎骨的水平处获得，而不需要求助于重要的牵引力。该技术根据不同类型的曲率而变化。从1983年到1985年，大约有250名病人接受了手术。对于特发性脊柱侧弯，平均矫正百分比为66%。在柔性曲线中观察到相关矢状变形和心尖去旋转的重要改善。在麻痹曲线，特别是骨盆畸形，正面变形的纠正率为77%。所有的脊柱患者在术后第一周内都能走动，没有任何外部支持，并返回学校或家庭活动。在43例随访时间超过两年的患者中，38例没有技术错误。无误差组的最终矫正角度丢失小于2度。
A new instrumentation for posterior spinal surgery consists of metallic rods carved with diamond-shaped asperities on which vertebral hooks or screws can be screwed in any position, level, or degree of rotation. The rods are interlocked by means of devices for transverse traction (DTTs), rectangular constructs with multiple vertebral grips, the stability of which allows suppression of any postoperative external support. Initially designed to treat scoliosis, this instrumentation design allows mobilization of the vertebrae located at the apex of the curve and obtains a three-dimensional correction. Correction of the areas of the most important structural deformation can also be obtained at the level of the end vertebrae, without any need to resort to an important distraction force. The technique varies according to the various types of curvatures. Approximately 250 patients were operated upon from 1983 to 1985. In idiopathic scoliotic curvatures, the mean percentage of correction was 66%. An important improvement of the associated sagittal deformations and of the apical derotation was observed in flexible curves. In paralytic curves, particularly with a pelvic obliquity, the percentage of correction of the frontal deformation is 77%. All of the spine patients were ambulatory in the first postoperative week, without any external support, and returned to their school or family activities. In 43 patients with follow-up periods longer than two years, there were no technical errors in 38. The final angular loss of correction was less than 2 degrees in the error-free group.