Long-term three-dimensional changes of the spine after posterior spinal instrumentation and fusion in adolescent idiopathic scoliosis

被引：0

作者：

P. Papin

H. Labelle

S. Delorme

C.-E. Aubin

J. A. de Guise

J. Dansereau

机构：

[1] Division of Orthopedic Surgery,

[2] Sainte-Justine Hospital,undefined

[3] Montreal,undefined

[4] Quebec,undefined

[5] Canada,undefined

[6] Division of Orthopedic Surgery,undefined

[7] Sainte-Justine Hospital,undefined

[8] 3175 Côte-Sainte-Catherine Road,undefined

[9] Montreal,undefined

[10] Quebec,undefined

[11] H3T 1C5 Canada,undefined

[12] and Research Center,undefined

[13] Sainte-Justine Hospital,undefined

[14] Montreal,undefined

[15] Quebec,undefined

[16] Canada Tel.: +1-514-345-4876; Fax: +1-514-345-4755 e-mail: hubert@justine.umontreal.ca,undefined

[17] Research Center,undefined

[18] Sainte-Justine Hospital,undefined

[19] Montreal,undefined

[20] Quebec,undefined

[21] Canada,undefined

[22] Research Center,undefined

[23] Sainte-Justine Hospital,undefined

[24] Montreal,undefined

[25] and Department of Mechanical Engineering,undefined

[26] École Polytechnique,undefined

[27] Montral,undefined

[28] Quebec,undefined

[29] Canada,undefined

[30] Research Center,undefined

[31] Sainte-Justine Hospital,undefined

[32] Montreal,undefined

[33] and Department of Automated Production Engineering,undefined

[34] École Technologie Supérieure,undefined

[35] Montreal,undefined

[36] Quebec,undefined

[37] Canada,undefined

来源：

European Spine Journal | 1999年 / 8卷

关键词：

Key words Adolescent idiopathic; scoliosis; Spinal instrumentation; Spine length; 3D correction;

D O I：

暂无

中图分类号：

学科分类号：

摘要：

This is a prospective study comparing the short- and long-term three-dimensional (3D) changes in shape, length and balance of the spine after spinal instrumentation and fusion in a group of adolescents with idiopathic scoliosis. The objective of the study was to evaluate the stability over time of the postoperative changes of the spine after instrumentation with multi rod, hook and screw instrumentation systems. Thirty adolescents (average age: 14.5 ± 1.6 years) undergoing surgery by a posterior approach had computerized 3D reconstructions of the spine done at an average of 3 days preoperatively (stage I), and 2 months (stage II) and 2,5 years (stage III) after surgery, using a digital multi-planar radiographic technique. Stages I, II and III were compared using various geometrical parameters of spinal length, curve severity, and orientation. Significant improvement of curve magnitude between stages I and II was documented in the frontal plane for thoracic and lumbar curves, as well as in the orientation of the plane of maximum deformity, which was significantly shifted towards the sagittal plane in thoracic curves. However, there was a significant loss of this correction between stages II and III. Slight changes were noted in apical vertebral rotation, in thoracic kyphosis and in lumbar lordosis. Spinal length and height were significantly increased at stage II, but at long-term follow-up spinal length continued to increase while spinal height remained similar. These results indicate that although a significant 3D correction can be obtained after posterior instrumentation and fusion, a significant loss of correction and an increase in spinal length occur in the years following surgery, suggesting that a crankshaft phenomenon may be an important factor altering the long-term 3D correction after posterior instrumentation of the spine for idiopathic scoliosis.

引用

页码：16 / 21

页数：5