脊柱-骨盆固定如何影响成年脊柱形的术后补偿机制?
Wang Zhi1, Ghassan Boubez1, Fidaa Al-Shakfa1
1Department of Orthopedic Surgery, University of Montreal Health Center, Montreal, QC, Canada.
Global spine journal
|September 8, 2023
概括
骨盆固定类型影响成人形手术中脊柱平衡补偿. 与部螺丝 (IS) 相比,S2-alar-iliac螺丝 (S2AI) 导致更多的膝盖补偿和较少的骨盆补偿.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 整形外科 整形外科 整形外科
- 生物机械工程 生物机械工程
背景情况:
- 成年脊柱形 (ASD) 通常需要复杂的手术纠正与脊椎骨盆固定.
- 在手术后保持斜腿平衡对于功能结果至关重要.
- 盆腔固定方法,如S2-alar-iliac (S2AI) 螺丝和腹腔螺丝 (IS),旨在稳定脊椎和盆腔.
研究的目的:
- 在ASD患者中,比较S2AI和IS骨盆固定之间的松平衡的术后补偿机制.
- 为了评估不同的骨盆固定类型如何影响骨盆倾斜,交叉斜率和手术后膝盖 flexion.
主要方法:
- 一个中心的回顾性队列研究,涉及多名外科医生.
- 包括手术后PI-LL不匹配>10°的ASD患者在脊椎骨盆固定后.
- 分析了各种脊椎和骨盆参数的手术前和1年后EOS成像数据,并比较了S2AI和IS组之间的变化.
主要成果:
- 两个S2AI (n=53) 和IS (n=26) 组在基线时都是可比的.
- 与IS组相比,S2AI组的十字斜率 (ΔSS:9.87°与13.2°相比,P=.001) 和膝盖屈曲角度 (ΔKFA:6.01°与3.06°相比,P=.02) 的变化明显更大.
- 骨盆倾斜 (ΔPT) 的变化在各组之间是相似的 (P=.42).
结论:
- 骨盆固定类型显著影响ASD患者的手术后斜腰平衡补偿.
- 与IS相比,S2AI螺丝促进了更大的补偿膝盖曲和更少的骨盆补偿.
- 这种差异可能归因于增加SI关节松性和IS固定的阴茎连接器上的机械应力.
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