ApiFix系统治疗青少年特发性脊柱侧弯的临床疗效

Clinical outcomes of ApiFix system for surgical treatment of adolescent idiopathic scoliosis

目的观察ApiFix系统治疗青少年特发性脊柱侧弯(adolescent idiopatic scoliosis,AIS)的临床疗效。方法根据纳入和排除标准,前瞻性选择2018年10月至2019年3月在新加坡国立大学医院就诊的28例AIS病人纳入本研究,分别采用ApiFix系统(研究组,9例)和传统后路钉棒系统(对照组,19例)进行治疗,通过比较两组的手术时间、术中出血量、切口长度评价手术创伤程度;通过比较术前、术后的影像学资料(主弯Cobb角和主弯矫正率)评价手术效果;观察随访期间的并发症发生情况。结果研究组的手术时间、术中出血量、切口长度分别为(143.33±25.00)min、(116.67±25.00)ml、(11.00±1.73)cm,均显著优于对照组,差异均有统计学意义(P均<0.05)。随访(6.57±1.40)个月(5~9个月),对照组出现邻近节段退变1例、螺钉松动1例、神经系统并发症1例,并发症发生率为15.79%(3/19),研究组未见并发症发生。两组病人术后及末次随访时的主弯Cobb角和矫正率比较,差异均无统计学意义(P均>0.05)。结论采用ApiFix系统治疗AIS,手术创伤小、围手术期并发症少、短期临床效果满意,值得临床推广。

Objective To observe the clinical outcomes of ApiFix system for surgical treatment of adolescent idiopathic scoliosis(AIS).Methods Total of 28 cases of AIS treated in National University Hospital of Singapore from October 2018 to March 2019 were selected according to the inclusion criteria and exclusion criteria.The patients were treated with ApiFix system(study group,9 cases)and traditional pedicle screw and rod system(control group,19 cases).Operation time,intraoperative blood loss,and incision length were compared between two groups to evaluate surgical injuries.Pre operative and post operative imaging parameters such as Cobb angles and correct rates were compared between two groups to evaluate clinical outcomes.Complications were observed during the follow up period.Results The operation time,intraoperative blood loss,and incision length in the study group were(143.33±25.00)min,(116.67±25.00)ml,and(11.00±1.73)cm,which were significantly reduced as compared with those in the control group(all P<0.05).During the follow up period(6.57±1.40 months,5 9 months),adjacent segment degeneration(one case),screw loosening(one case),and neurological complication(one case)occurred in the control group,and the complication rate was 15.79%(3/19).No complications occurred in the study group.There was no significant difference in the Cobb angle and the correction rate of the main curve between the two groups after surgery and at the last follow up(P>0.05).Conclusion ApiFix system was an option in AIS cases for its minimal invasion,less intra operative period complications,and satisfactory short term clinical outcomes.