CHANGES IN SHAPE OF THE ADOLESCENT IDIOPATHIC SCOLIOSIS CURVE AFTER SURGICAL-CORRECTION

被引:12
作者
STOKES, IAF
RONCHETTI, PJ
ARONSSON, DD
机构
[1] Department of Orthopaedics and Rehabilitation, University of Vermont, Burlington, VT
关键词
Curve shape; Harrington distraction instrumentation; Radiology; Scoliosis; Spinal arthrodesis; Surgery;
D O I
10.1097/00007632-199405000-00005
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Design. The effect of spinal instrumentation in idiopathic scoliosis was studied in 21 patients who had Harrington instrumentation and 15 who had Wisconsin-Drummond instrumentation. Objective. Radiographs were analyzed to determine if the frontal and transverse plane shape of the scoliosis curve was changed by surgery, with and without segmental fixation. Summary of Background Data. Previous reports were based on frontal plane measurements of the curve (Cobb angle). The study reports correction in the frontal plane (Cobb angle) and transverse plane (apical vertebral rotation), as well as the regional distribution of the correction. Methods. Radiographs before surgery, soon after, and between 5 and 48 months after surgery were marked and digitized to measure the regional distribution of the frontal plane shape and transverse plane vertebral rotation. Results. Despite improvement in the magnitude of the deformity, the scoliosis curve shape remained almost constant postoperatively. There was minimal correction of the apical vertebra axial rotation in either group. Conclusion. This study documents that although the Harrington and Wisconsin-Drummond instrumentation systems decrease the Cobb angle, they do not change the shape of the curve or correct apical vertebra axial rotation. Newer instrumentation designs need to look beyond the Cobb angle as the only measure of outcome.
引用
收藏
页码:1032 / 1038
页数:7
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  • [1] Aaro S., Dahlborn M., The effect of Harrington instrumen-tation on the longitudinal axis of the apical vertebra and on the spinal and rib cage deformity in idiopathic scoliosis studied by computer tomography, Spine, 7, pp. 456-462, (1982)
  • [2] Appelgren G., Willner S., End vertebra angle—a roentgen- ographic method to describe scoliosis, a follow-up study of idiopathic scoliosis treated with the Boston brace, Spine, 15, pp. 71-74, (1990)
  • [3] Bassett G.S., Hensinger B.S., Keiper M.D., Effect of posterior spinal fusion on spinal balance in idiopathic scoliosis, J Pediatr Orthop, 9, pp. 672-674, (1989)
  • [4] Ben Son D.R., Dewald R.L., Schultz A.B., Harrington rod detraction instrumentation. Its effect on vertebral rotation and thoracic compensation, Clin Orthop, 125, pp. 40-44, (1977)
  • [5] Cundy P.J., Paterson D.C., Hillier T.M., Sutherland A.D., Stephen J.P., Foster B.K., Cotrel Dubousset instrumentation and vertebral rotation in adolescent idiopathic scoliosis, J Bone Joint Surg [Br], 72, pp. 670-674, (1990)
  • [6] Dickson R.A., Archer I.A., Surgical treatment of late onset idiopathic thoracic scoliosis. The Leeds procedure, J Bone Joint Surg [Br], 69, pp. 709-714, (1987)
  • [7] Drummond D., Guadagni J., Keene J.S., Narechania R., Interspinous process segmental spinal instrumentation, J Pediatr Orthop, 4, pp. 397-404, (1984)
  • [8] Ecker M.L., Betz R.R., Trent P.S., Et al., Computer tomography evaluation of Cotrel-Dubousset instrumentation in idiopathic scoliosis, Spine, 13, pp. 1141-1144, (1988)
  • [9] Gaines R.W., McKinley C.M., Leatherman K.D., Effect of the Harrington compression system on the correction of the rib hump in spinal instrumentation for idiopathic scoliosis, Spine, 6, pp. 489-493, (1981)
  • [10] Harrington P.R., Treatment of scoliosis. Correction and internal fixation by spine instrumentation, J Bone Joint Surg [Am], 44, pp. 591-611, (1962)