Abstract:Objective to explore the effectof new fulcrum bending film technique on fusion strategy of adolescent idiopathic scoliosis.Methods Based on new-designed fulcrum bending film technique,the fusion level of 23 AIS patients,which enrolled from June 2013 to April 2014,was identified before scoliosis operation.The study cohort had a mean age of 14.8 years(10~19 years) of which 18 were female and 5 male.AS regarded to Lenke classification,there 13 type 1AN,4 type 1BN,1 type 1A- and 5 type 1CN.Besides radiological measurements were taken from Long-cassette standing anteroposterior film preoperative,immediate postoperative(1 week)and latest follow-up,fulcrum bending film was measured preoperatively.According to magnitude of Cobb angle,reservation of fusion segments could be calculated.Results there was no statistically different between average Cobb angle of new fulcrum bending film preoperatively and that of anteroposterior standing film immediate postoperative(t=0.7,P=0.483);and no significant changes appeared in the period from immediate postoperative to latest visit (t=5.5,P=0.001).17 of 23 population reserved one more motion segments compared with traditional Harrington technique.Conclusion New fulcrum bending film technique could safely evaluated the selection of fusion level in AIS patients.In contrast with traditional method,it could reserve more fusion vertebrae,saving more motion segments of spine.
杨依林,王飞,栗景峰,魏显招,陈自强,朱晓东,李明 *. 新型支点侧屈位X线片在脊柱侧凸中的应用研究[J]. 实用骨科杂志, 2017, 23(3): 208-211.
Yang Yilin,Wang Fei,Li Jingfeng,et al. The Application Research of New Fulrum Bending X-ray Films in Scoliosis. sygkzz, 2017, 23(3): 208-211.
[1]Sudo H,Kaneda K.Short fusion strategy for thoracolumbar and lumbar adolescent idiopathic scoliosis using anterior dual-rod instrumentation[J].Bone Joint J,2016,98(3):402-409.
[2]Suk SI.Pedicle screw instrumentation for adolescent idiopathic scoliosis:the insertion technique,the fusion levels and direct vertebral rotation[J].Clin Orthop Surg,2011,3(2):89-100.
[3]Suk SI,Lee SM.Selective thoracic fusion with segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis:more than 5-year follow-up[J].Spine (Phila Pa 1976),2005,30(14):1602-1609.
[4]Lenke LG,Betz RR.Spontaneous lumbar curve coronal correction after selective anterior or posterior thoracic fusion in adolescent idiopathic scoliosis[J].Spine (Phila Pa 1976),1999,24(16):1663-1771.
[5]Samartzis D,Leung Y.Selection of fusion levels using the fulcrum bending radiograph for the management of adolescent idiopathic scoliosis patients with alternate level pedicle screw strategy:clinical decision-making and outcomes[J].Plos One,2015,10(8):e0120302.
[6]Li J,Hwang S,Wang F,et al.An innovative fulcrum-bending radiographical technique to assess curve flexibility in patients with adolescent idiopathic scoliosis[J].Spine (Phila Pa 1976),2013,38(24):E1527-1532.
[7]Luk KD,Don AS,Chong CS,et al.Selection of fusion levels in adolescent idiopathic scoliosis using fulcrum bending prediction:a prospective study[J].Spine (Phila Pa 1976),2008,33(20):2192-2198.
[8]Harrington PR.Treatment of scoliosis:correction and internal fixation by spine instrumentation[J].J Bone Joint Surg Am,2002,84(2):316.
[9]Lenke LG,Edwards CC II,Bridwell KH.The Lenke classification of adolescent idiopathic scoliosis:How it organizes curve patterns as a template to perform selective fusions of the spine[J].Spine(Phila Pa 1976),2003,28(20):199-207.
[10]Suk SI,Lee SM,Chung ER,et al.Determination of distal fusion level with segmental pedicle screw fixation in single thoracic idiopathic scoliosis[J].Spine (Phila Pa1976),2003,28(5):484-491.