ผลการรักษาภาวะกระดูกสันหลังคดชนิดไม่ทราบสาเหตุในวัยรุ่นด้วยการผ่าตัดยึดกระดูกทางด้านหลังเพียงอย่างเดียวในโรงพยาบาลศิริราช
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เม.ย. 30, 2010
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บทคัดย่อ
การศึกษาแบบย้อนหลังในการแก้ไขภาวะกระดูกสันหลังคดชนิดไม่ทราบสาเหตุในวัยรุ่น ด้วยวิธีผ่าตัดทางด้านหลังในผู้ป่วย 37 ราย ซึ่งได้ติดตามผลเป็นเวลาอย่างน้อย 2 ปี แสดงให้เห็นว่าการผ่าตัดทางด้านหลังเป็นวิธีที่ได้ผลดี สามารถแก้ไขภาวะกระดูกสันหลังคดในรายที่มีมุมกระดูกสันหลังคดมากกว่า 90 องศา โดยไม่พบความแตกต่างของการแก้ไขความผิดปกติทั้งใน frontal plane และ sagittal plane ระหว่าง pedicle screw constructs และ hybrid constructs และพบว่าการผ่าตัดให้ผลไม่แตกต่างกันในกลุ่มผู้ป่วยที่มีลักษณะกระดูกสันหลังคดในแต่ละแบบตาม Lenke classitication นอกจากนี้ยังพบความสัมพันธ์อย่างมีนัยสำคัญระหว่าง proximal junctional kyphosis, hybrid instrumentation (proximal hooks and distal pedicle screws) และ preoperative larger sagittal thoracic angle (T5-T12 ³ 400)
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เอกสารอ้างอิง
1. Stokes IA, Bigalow LC, Moreland MS. Three-dimensional spinal curvature in idiopathic scoliosis. J Orthop Res. 1987; 5(1): 102-13.
2. Villemure I, Aubin CE, Grimard G, Dansereau J, Labelle H. Progression of vertebral and spinal three dimensional deformities in adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2001; 26(20): 2244-50.
3. Moe JH. Methods of correction and surgical techniques in scoliosis. Orthop Clin North Am. 1972; 3(1): 17-48.
4. Goldstein LA. The surgical management of scoliosis. Clin Orthop Relat Res. 1964; 35: 95-115.
5. Bridwell KH. Surgical treatment of idiopathic adolescent scoliosis. Spine (Phila Pa 1976). 1999; 24(24): 2607-16.
6. Behensky H, Krismer M, Bauer R. Comparison of spinal mobility after Harrington and CD instrumentation. J Spinal Disord. 1998; 11(2): 155-62.
7. Benli IT, Akalin S, Kiş M, Citak M, Aydin E, Duman E. Frontal and sagittal balance analysis of late onset idiopathic scoliosis treated with third generation instrumentation. Kobe J Med Sci. 2001; 47(6): 231-53.
8. McCance SE, Denis F, Lonstein JE, Winter RB. Coronal and sagittal balance in surgically treated adolescent idiopathic scoliosis with the King II curve pattern. A review of 67 consecutive cases having selective thoracic arthrodesis. Spine (Phila Pa 1976). 1998; 23(19): 2063-73.
9. Nowakowski A, Labaziewicz L. Surgical treatment of idiopathic scoliosis with multisegmental posterior instrumentation and its influence on postoperative spinal balance. Chir Narzadow Ruchu Ortop Pol. 1997; 62(5): 407-13.
10. Suk SI, Lee CK, Chung SS. Comparison of Zielke VDS and Cotrel-Dubousset instrumentation in the treatment of idiopathic lumbar and thoracolumbar scoliosis. Spine (Phila Pa 1976). 1994; 19(4): 419-29.
11. Chen SH, Huang TJ, Lee YY, Hsu RW. Pulmonary function after thoracoplasty in adolescent idiopathic scoliosis. Clin Orthop Relat Res. 2002(399): 152-61.
12. Graham EJ, Lenke LG, Lowe TG, Betz RR, Bridwell KH, Kong Y, et al. Prospective pulmonary function evaluation following open thoracotomy for anterior spinal fusion in adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2000; 25(18): 2319-25.
13. Suk SI, Lee CK, Min HJ, Cho KH, Oh JH. Comparison of Cotrel-Dubousset pedicle screws and hooks in the treatment of idiopathic scoliosis. Int Orthop. 1994; 18(6): 341-6.
14. Halm H, Niemeyer T, Link T, Liljenqvist U. Segmental pedicle screw instrumentation in idiopathic thoracolumbar and lumbar scoliosis. Eur Spine J. 2000; 9(3): 191-7.
15. Hamill CL, Lenke LG, Bridwell KH, Chapman MP, Blanke K, Baldus C. The use of pedicle screw fixation to improve correction in the lumbar spine of patients with idiopathic scoliosis: is it warranted?. Spine. 1996; 21(10): 1241-9.
16. Lonstein JE, Denis F, Perra JH, Pinto MR, Smith MD, Winter RB. Complications associated with pedicle screws. J Bone Joint Surg Am. 1999; 81(11): 1519-28.
17. Gaines RW Jr. The use of pedicle-screw internal fixation for the operative treatment of spinal disorders. J Bone Joint Surg Am. 2000; 82(10): 1458-76.
18. Suk S, Kim WJ, Lee SM, Chung YJ, Park YB. Segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis. Spine. 1995; 20: 49-57.
19. Lee GA, Betz RR, Clements DH 3rd, Huss GK. Proximal kyphosis after posterior spinal fusion in patients with idiopathic scoliosis. Spine (Phila Pa 1976). 1999; 24(8): 795-9.
20. Rhee JM, Bridwell KH, Won DS, Lenke LG, Chotigavanichaya C, Hanson DS. Sagittal plane analysis of adolescent idiopathic scoliosis: the effect of anterior versus posterior instrumentation. Spine (Phila Pa 1976). 2002; 27(21): 2350-6.
21. Kim YJ, Lenke LG, Bridwell KH, Kim J, Cho SK, Cheh G, Yoon J. Proximal junctional kyphosis in adolescent idiopathic scoliosis after 3 different types of posterior segmental spinal instrumentation and fusion. Spine. 2007; 32: 2731-8.
22. Dwyer AF, Schafer MF. Anterior approach to scoliosis. J Bone Joint Surg Br. 1974; 56(2): 218-24.
23. Zielke K, Pellin B. Neue Instrumente and Implantate zur Erganzung des Harrington Systems. Z Orthop Chir. 1976; 114: 534.
24.Hamill CL, Lenke LG, Bridwell KH, Chapman MP, Blanke K, Baldus C. The use of pedicle screw fixation to improve correction in the lumbar spine of patients with idiopathic scoliosis. Is it warranted? Spine. 1996; 21(10): 1241-9.
25. Liljenqvist U, Lepsien U, Hackenberg L, Niemeyer T, Halm H. Comparaive analysis of pedicle screw and hook instrumentation in posterior correction and fusion of idiopathic thoracic scoliosis. Eur Spine J. 2002; 11(4): 336-43.
26. Storer SK, Vitale MG, Hyman JE, Lee FY, Choe JC, Roye DP Jr. Correction of adolescent idiopathic scoliosis using thoracic pedicle screw fixation versus hook constructs. J Pediatr Orthop. 2005; 25(4): 415-9.
27. Kim YJ, Lenke LG, Kim J, Bridwell KH, Cho SK, Cheh G, et al. Comparative analysis of pedicle screw versus hybrid instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis. Spine. 2006; 31(3): 291-8.
28. Lowenstein JE, Matsumoto H, Vitale MG, Weidenbaum M, Gomez JA, Lee FY. Coronal and sagittal plane correction in adolescent idiopathic scoliosis: A comparison between all pedicle screw versus hybrid thoracic hook lumbar screw constructs. Spine (Phila Pa 1976). 2007; 32(4): 448-52.
29. Lenke LG, Bridwell KH, O’Brien MF, Baldus C, Blanke K. Recognition and treatment of proximal thoracic curve in adolescent idiopathic scoliosis treated with cotrel-dubousset instrumentation. Spine. 1994; 19(14): 1589-97.
2. Villemure I, Aubin CE, Grimard G, Dansereau J, Labelle H. Progression of vertebral and spinal three dimensional deformities in adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2001; 26(20): 2244-50.
3. Moe JH. Methods of correction and surgical techniques in scoliosis. Orthop Clin North Am. 1972; 3(1): 17-48.
4. Goldstein LA. The surgical management of scoliosis. Clin Orthop Relat Res. 1964; 35: 95-115.
5. Bridwell KH. Surgical treatment of idiopathic adolescent scoliosis. Spine (Phila Pa 1976). 1999; 24(24): 2607-16.
6. Behensky H, Krismer M, Bauer R. Comparison of spinal mobility after Harrington and CD instrumentation. J Spinal Disord. 1998; 11(2): 155-62.
7. Benli IT, Akalin S, Kiş M, Citak M, Aydin E, Duman E. Frontal and sagittal balance analysis of late onset idiopathic scoliosis treated with third generation instrumentation. Kobe J Med Sci. 2001; 47(6): 231-53.
8. McCance SE, Denis F, Lonstein JE, Winter RB. Coronal and sagittal balance in surgically treated adolescent idiopathic scoliosis with the King II curve pattern. A review of 67 consecutive cases having selective thoracic arthrodesis. Spine (Phila Pa 1976). 1998; 23(19): 2063-73.
9. Nowakowski A, Labaziewicz L. Surgical treatment of idiopathic scoliosis with multisegmental posterior instrumentation and its influence on postoperative spinal balance. Chir Narzadow Ruchu Ortop Pol. 1997; 62(5): 407-13.
10. Suk SI, Lee CK, Chung SS. Comparison of Zielke VDS and Cotrel-Dubousset instrumentation in the treatment of idiopathic lumbar and thoracolumbar scoliosis. Spine (Phila Pa 1976). 1994; 19(4): 419-29.
11. Chen SH, Huang TJ, Lee YY, Hsu RW. Pulmonary function after thoracoplasty in adolescent idiopathic scoliosis. Clin Orthop Relat Res. 2002(399): 152-61.
12. Graham EJ, Lenke LG, Lowe TG, Betz RR, Bridwell KH, Kong Y, et al. Prospective pulmonary function evaluation following open thoracotomy for anterior spinal fusion in adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2000; 25(18): 2319-25.
13. Suk SI, Lee CK, Min HJ, Cho KH, Oh JH. Comparison of Cotrel-Dubousset pedicle screws and hooks in the treatment of idiopathic scoliosis. Int Orthop. 1994; 18(6): 341-6.
14. Halm H, Niemeyer T, Link T, Liljenqvist U. Segmental pedicle screw instrumentation in idiopathic thoracolumbar and lumbar scoliosis. Eur Spine J. 2000; 9(3): 191-7.
15. Hamill CL, Lenke LG, Bridwell KH, Chapman MP, Blanke K, Baldus C. The use of pedicle screw fixation to improve correction in the lumbar spine of patients with idiopathic scoliosis: is it warranted?. Spine. 1996; 21(10): 1241-9.
16. Lonstein JE, Denis F, Perra JH, Pinto MR, Smith MD, Winter RB. Complications associated with pedicle screws. J Bone Joint Surg Am. 1999; 81(11): 1519-28.
17. Gaines RW Jr. The use of pedicle-screw internal fixation for the operative treatment of spinal disorders. J Bone Joint Surg Am. 2000; 82(10): 1458-76.
18. Suk S, Kim WJ, Lee SM, Chung YJ, Park YB. Segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis. Spine. 1995; 20: 49-57.
19. Lee GA, Betz RR, Clements DH 3rd, Huss GK. Proximal kyphosis after posterior spinal fusion in patients with idiopathic scoliosis. Spine (Phila Pa 1976). 1999; 24(8): 795-9.
20. Rhee JM, Bridwell KH, Won DS, Lenke LG, Chotigavanichaya C, Hanson DS. Sagittal plane analysis of adolescent idiopathic scoliosis: the effect of anterior versus posterior instrumentation. Spine (Phila Pa 1976). 2002; 27(21): 2350-6.
21. Kim YJ, Lenke LG, Bridwell KH, Kim J, Cho SK, Cheh G, Yoon J. Proximal junctional kyphosis in adolescent idiopathic scoliosis after 3 different types of posterior segmental spinal instrumentation and fusion. Spine. 2007; 32: 2731-8.
22. Dwyer AF, Schafer MF. Anterior approach to scoliosis. J Bone Joint Surg Br. 1974; 56(2): 218-24.
23. Zielke K, Pellin B. Neue Instrumente and Implantate zur Erganzung des Harrington Systems. Z Orthop Chir. 1976; 114: 534.
24.Hamill CL, Lenke LG, Bridwell KH, Chapman MP, Blanke K, Baldus C. The use of pedicle screw fixation to improve correction in the lumbar spine of patients with idiopathic scoliosis. Is it warranted? Spine. 1996; 21(10): 1241-9.
25. Liljenqvist U, Lepsien U, Hackenberg L, Niemeyer T, Halm H. Comparaive analysis of pedicle screw and hook instrumentation in posterior correction and fusion of idiopathic thoracic scoliosis. Eur Spine J. 2002; 11(4): 336-43.
26. Storer SK, Vitale MG, Hyman JE, Lee FY, Choe JC, Roye DP Jr. Correction of adolescent idiopathic scoliosis using thoracic pedicle screw fixation versus hook constructs. J Pediatr Orthop. 2005; 25(4): 415-9.
27. Kim YJ, Lenke LG, Kim J, Bridwell KH, Cho SK, Cheh G, et al. Comparative analysis of pedicle screw versus hybrid instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis. Spine. 2006; 31(3): 291-8.
28. Lowenstein JE, Matsumoto H, Vitale MG, Weidenbaum M, Gomez JA, Lee FY. Coronal and sagittal plane correction in adolescent idiopathic scoliosis: A comparison between all pedicle screw versus hybrid thoracic hook lumbar screw constructs. Spine (Phila Pa 1976). 2007; 32(4): 448-52.
29. Lenke LG, Bridwell KH, O’Brien MF, Baldus C, Blanke K. Recognition and treatment of proximal thoracic curve in adolescent idiopathic scoliosis treated with cotrel-dubousset instrumentation. Spine. 1994; 19(14): 1589-97.
