- 有料閲覧
- 文献概要
- 1ページ目
- 参考文献
重度側弯症に対する手術成績と問題点について,フック,ワイヤー,椎弓根スクリューを用いたhybrid法(H法)と椎弓根スクリュー単独のPS法とを比較検討した.術前Cobb角80°以上の26例(男3,女23,平均年齢14歳)を対象とした.検討項目は1)術前,術後X線所見,2)周術期・術後の合併症とした.主カーブのCobb角は術前H群平均95.8±11.9°(flexibility 36.2±17.4%),PS群98.2±12.9°(同31.6±20.8%),調査時53.2±18.7°,39.4±17.4°,最終矯正率は45.2±16.6%,60.7±15.0%(p=0.02)であった.手術時間はH群平均512.5±170.8分,PS群359.9±123.7分,出血量922.9±518.6g,706.7±475.8gであった.全体的な合併症発生率はH群45.5%,PS群36.5%であり,PS群で低い傾向であった.重度側弯症に対する手術療法は手術時間,出血量も多く,合併症の頻度も高かったが,両群とも最終的に一定の矯正が得られた.PS法は技術的には困難ではあるが,H法と同等以上の手術成績が得られる重度側弯症に対する有用な方法であると考えられた.
Twenty-six patients (3 males and 23females, mean age 14years) with a curve magnitude of more than 80 degrees were treated either with a hybrid construct (H group) or by a pedicle screw only construct (PS group). The Cobb angle of the main curve was 95.8±11.9° in the H group and 98.2±12.9° in the PS group before surgery and 53.2±18.7° and 39.4±17.4°, respectively, at follow-up (correction rate:45.2% and. 60.7%, p=0.02, respectively). Mean operation time and estimated blood loss were 512.5min and 922.9g, respectively, in the H group and 359.9min and 706.7g, respectively, in the PS group (p<0.05). The PS construct provided a better surgical outcome than the H construct as well as a shorter operation time and smaller volume of blood loss, and it is an effective surgical option for the treatment of severe scoliosis.
Copyright © 2009, Igaku-Shoin Ltd. All rights reserved.