椎板钩和椎弓根钉系统治疗脊柱侧凸病例对照研究

Laminar hook versus pedicle screw in the posterior correction and arthrodesis for idiopathic scoliosis

目的 探讨脊柱椎弓根钉系统治疗脊柱侧凸是否安全 ,是否可以矫正出更好的曲线 ,是否能达到更短节段的融合。方法 5 0例特发性脊柱侧凸患者中 2 5例采用椎板钩系统手术 (椎板钩组 ) ,2 5例采用上胸段椎板钩、下胸段和腰段椎弓根钉联合术式或者完全用椎弓根钉系统手术 (椎弓根钉组 )。比较两组矫正曲线、融合长度以及并发症发生率。结果 随访 1～ 8年 ,曲线校正 :椎弓根钉组达 5 0 1% ,明显好于椎板钩组的4 1 1%。矢状面畸形的矫正 :两组没有区别。融合长度 :椎弓根钉组较椎板钩组平均少 0 6个锥体。

Objective To investigate the application of pedicle screw in the surgical treatment of idiopathic scoliosis. Methods 50 cases of idiopathic scoliosis were enrolled, 25 of which were treated with laminar hook (laminar hook group) and 25 were treated with laminar hook in superior thoracic spine and combination of laminar hook and pedicle screw in inferior thoracic spine and lumbar spine, or totally pedicle screw (pedicle screw group). The corrective curves, the length or arthrodesis and the rates of complication were compared. Results All of the cases were followed up from 1 to 8 years. The ratio of curve correction was 50.1% in pedicle screw grow and 41.1% in laminar hook group. The corrections of sagittal deformity had no diffenence between the two groups. The length of arthrodesis was 0.6 vertebral height shorther in pedicle screw group than that in laminar hook group. Conclusion Pedicle screw is much better in the correction of lateral curvature than laminar hook.