Adolescent idiopathic scoliosis correction achieved by posteromedial translation using polyester bands: A comparative study of subtransverse process versus sublaminar fixation

被引:17
作者
Hirsch, C. [1 ]
Ilharreborde, B. [2 ]
Fournier, J. [3 ]
Mazda, K. [2 ]
Bonnard, C. [3 ]
机构
[1] Univ Paris Diderot, Beaujon Hosp, AP HP, Dept Orthoped, F-92110 Clichy, France
[2] Univ Paris Diderot, Hop Robert Debre, AP HP, Pediat Orthoped Dept, Paris, France
[3] Univ Tours, Clocheville Pediat Hosp, Pediatr Orthoped Dept, Tours, France
关键词
Adolescent idiopathic scoliosis; Posteromedial translation; Hybrid construct; Universal clamp; PEDICLE SCREW; THORACIC SPINE; VERTEBRAL DEROTATION; POSTERIOR TREATMENT; INSTRUMENTATION; HYBRID; FUSION; CONSTRUCTS; ROTATION; KYPHOSIS;
D O I
10.1016/j.otsr.2014.07.019
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose: Sublaminar polyester bands have been used in hybrid construct to achieve correction of adolescent idiopathic scoliosis since 2003. Despite the reported safety of the bands, some surgeons remain reluctant at the idea of approaching the canal because of the potential neurological complications reported with the Luque wiring. Sub transverse bands might be an alternative. The present study is the first to compare sublaminar polyester band fixation to fixation of polyester bands around the transverse processes in hybrid constructs used to treat AIS. Methods: Two cohorts of consecutive patients treated for thoracic AIS were retrospectively reviewed, with a minimum 2-year follow-up. Posteromedial translation was used for main curve correction in all cases. Sublaminar polyester bands were used in group 1 (20 patients). In group 2 (20 patients), the same implant was used, but the bands were passed around the transverse process instead of the lamina. Radiographic analysis included frontal Cobb angle measurements for each curve, thoracic kyphosis and rotation of the apical vertebra (RVA). Results: Mean operative time was similar in groups 1 and 2 (235 +/- 35 and 240 +/- 30 minutes, respectively). Mean frontal correction achieved for the main curve was similar in both groups, 62.5 +/- 17.4% in group 1 and 54.1 +/- 19.4% in group 2. Sagittal correction was similar, with a final mean thoracic kyphosis of 30.9 degrees +/- 9.7 degrees and 27.8 degrees +/- 6.8 degrees in group 1 and 2, respectively. Correction of RVA was similar in both groups postoperatively, 65.8% (+/- 29.1) and 54.4% (+/- 42.7) in group 1 and 2 respectively. No transverse process or lamina fracture was observed during insertion of the bands or curve correction in any of the groups. Conclusion: This study confirms that anchorage of Universal clamps (UCs) around transverse processes is a safe and efficacious technique in both the frontal and sagittal planes, providing a useful alternative for the correction of moderate AIS. UCs attached to transverse processes can achieve correction of moderate AIS similar to that obtained with sublaminar UCs while further reducing risks of vertebral canal complications. (C) 2014 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:791 / 795
页数:5
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