Skip pedicle screw fixation combined with Ponte osteotomy for adolescent idiopathic scoliosis

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• 作者：Jun Takahashi (1)
  Shota Ikegami (1)
  Shuugo Kuraishi (1)
  Masayuki Shimizu (1)
  Toshimasa Futatsugi (1)
  Hiroyuki Kato (1)
  
• 关键词：Adolescent idiopathic scoliosis ; Ponte osteotomy ; Correction rate ; Thoracic kyphosis ; Rod material
• 刊名：European Spine Journal
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：23
• 期：12
• 页码：2689-2695
• 全文大小：3,419 KB
• 参考文献：1. Cheung KM, Natarajan D, Samartzis D, Wong YW, Cheung WY, Luk KD (2010) Predictability of the fulcrum bending radiograph in scoliosis correction with alternate-level pedicle screw fixation. J Bone Joint Surg Am 92:169-76 CrossRef
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  3. Geck MJ, Macagno A, Ponte A, Shufflebarger HL (2007) The Ponte procedure: posterior only treatment of Scheuermann’s kyphosis using segmental posterior shortening and pedicle screw instrumentation. J Spinal Disord Tech 20:586-93 CrossRef
  4. Halanski MA, Cassidy JA (2013) Do multilevel Ponte osteotomies in thoracic idiopathic scoliosis surgery improve curve correction and restore thoracic kyphosis? J Spinal Disord Tech 26:252-55 CrossRef
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  14. Zhang G, Zhang Y, Zhang X, Wang Z, Mao K, Wang Y (2012) Restoration of thoracic kyphosis with multilevel Ponte osteotomies in thoracic idiopathic scoliosis surgery. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 26:1197-201 (in Chinese)
  
• 作者单位：Jun Takahashi (1)
  Shota Ikegami (1)
  Shuugo Kuraishi (1)
  Masayuki Shimizu (1)
  Toshimasa Futatsugi (1)
  Hiroyuki Kato (1)
  
  1. Departments of Orthopaedic Surgery, School of Medicine, Shinshu University, Matsumotoshi Asahi 3-1-1, Nagano, 390-8621, Japan
  
• ISSN：1432-0932

文摘

Purpose This study aimed to determine whether Ponte osteotomy combined with skip pedicle screw fixation (SPSF) can improve the correction rate and restore thoracic kyphosis for patients with adolescent idiopathic scoliosis. Methods Surgical time, blood loss, preoperative Cobb angle of the main thoracic curve, flexibility, Cobb angle at 1?year after surgery, thoracic curve correction rate, and Cincinnati correction index (CCI) were determined for both the Ponte (n?=?17) and non-Ponte (control; n?=?21) groups. Furthermore, kyphotic angles at T5–T12 before and 1?year after the surgery were measured. Results The following measurements were obtained for the Ponte and control groups, respectively: surgical time, 236?±?13 and 187?±?9?min; blood loss, 1,141?±?150 and 745?±?120?g; preoperative Cobb angle of the main thoracic curve, 52.5°?±?10.4° and 51.5°?±?9.2°; flexibility, 31.7?±?13.2 and 45.1?±?12.3?% (p?=?0.003); thoracic curve correction rate, 62.0?±?2.5 and 63.6?±?2.5?%; CCI, 2.2?±?0.2 and 1.5?±?0.1 (p?=?0.003); preoperative kyphotic angle at T5–T12, 11.3°?±?11.2° and 13.0°?±?9.0°; and kyphotic angle at T5–T12 at 1?year after the surgery, 21.8°?±?1.7° and 24.2°?±?1.9°. Conclusion Ponte osteotomy was combined with SPSF in case of rigid curve. CCI was significantly greater in the Ponte group. Postoperative thoracic kyphotic angles were identical in both groups.