伴有C型腰弯的特发性青少年脊柱侧凸的选择性胸椎融合：钩与椎弓根螺钉比较.pptVIP

* * Selective Thoracic Fusion For AIS With Lumbar “C” Modifier Curves: Comparison of Hooks Versus Pedicle Screws Introduction Classification schemes for Adolescent Idiopathic Scoliosis have attempted to identify patients with major thoracic and compensatory lumbar curves that are amenable to selective thoracic fusion in order to preserve lumbar motion segments. Improper patient selection may lead to postoperative coronal decompensation (C7 plumb line deviation from CSVL). Introduction Adolescent Idiopathic Scoliosis: A new classification to determine extent of spinal arthrodesis. Lenke L, Betz R, Harms J, Bridwell K, Clements D, Lowe T, Blanke K.; JBJS 2001:83A, 1169-1181 Lenke “C” curves (lumbar apical vertebra translated lateral to CSVL) are considered greatest risk of postoperative coronal decompensation Introduction Recent study has reported success with selective thoracic fusion in 44 patients with Lenke “C” curves Correction of apical translation was inconsistent: some remained “C” type curves while others corrected to “A” or “B” Preoperative global imbalance was a predictor of postoperative imbalance Selective thoracic fusion for AIS with “C” lumbar modifier curves: 2-16 year radiographic and clinical results. Dobbs, MB, Edwards CC, Lenke LG, Peelle MW, Sides B, Rinella A, Bridwell KH. Spine 2004; 29(5):536-546. COMPARATIVE ANALYSIS OF PEDICLE SCREW VS HOOK INSTRUMENTATION IN POSTERIOR SPINAL FUSION OF ADOLESCENT IDIOPATHIC SCOLIOSIS: A Matched Cohort Analysis Yongjung J. Kim, MD · Lawrence G. Lenke, MD Samuel K. Cho, MD · Keith H. Bridwell, MD Spinal Deformity Service Washington University School of Medicine St. Louis Shriners Hospital St. Louis, Missouri SRS 2003/AAOS 2004/POSNA 2004/ Spine, SRS issue 29S(18):2040-2058, 2004 METHODSWell Matched Cohorts Op. Methods # of Fused VB Lenke Curve Type Age at Surgery TPS N=26 PSF+TPL 18 PSF+ICBG 4 PSF+Ant BG 4 11.7 Type 1: 14 Type 2: 7 Type 3: 1 Type 4: 2 Type 6: 2 14.8Y Hook N=26 PSF+TP