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Abstract：
METHODS: A 2-year follow-up study.
OBJECTIVE: To evaluate the effectiveness of modified halo-pelvic Ilizarov distraction assembly in the management of patients with severe kyphoscoliosis.
BACKGROUND: Severe and rigid scoliosis curves are always a challenge for operating surgeons. Preoperative correction through halo-pelvic devices successfully minimizes the severity of the curve; however, cumbersome complications are also reported with its use. Modified assembly could be safe for these cases.
METHODS: Patients with severe kyphoscoliosis having coronal Cobb angle >90° were applied with modified halo-pelvic Ilizarov distraction assembly preoperatively. The modified assembly consisted of a pelvic component and halo ring, and distraction was given at the rate of 2-3 mm/day for 6-12 weeks. Complete clinical assessments along with pulmonary function tests were performed, and scoliosis series X-ray images were assessed for coronal and sagittal Cobb angle and other spinopelvic parameters before applying the assembly and during 2 years of follow-up.
RESULTS: Thirty-four patients (age, 9-27 years; male/female ratio of 18:16) were included. The coronal and sagittal Cobb angles were 116°±16.2° and 84°±28.3°, respectively. Correction rates obtained through modified halo-pelvic assembly were nearly 52% (p=0.001) in coronal and 40% (p=0.001) in sagittal Cobb angles, with improvement in height (p=0.001). Apical vertebral translation and coronal balance were also improved significantly (p=0.001). Further improvements in all the parameters were obtained after definitive surgery, with improvements in the forced expiratory volume in 1 second (p =0.002) and forced vital capacity (p=0.001).
CONCLUSIONS: Our modified halo-pelvic Ilizarov distraction assembly can achieve good correction in severe spinal deformities without significant risk to neurology, has fewer complications, and promotes good patient compliance.
OBJECTIVE: To evaluate the effectiveness of modified halo-pelvic Ilizarov distraction assembly in the management of patients with severe kyphoscoliosis.
BACKGROUND: Severe and rigid scoliosis curves are always a challenge for operating surgeons. Preoperative correction through halo-pelvic devices successfully minimizes the severity of the curve; however, cumbersome complications are also reported with its use. Modified assembly could be safe for these cases.
METHODS: Patients with severe kyphoscoliosis having coronal Cobb angle >90° were applied with modified halo-pelvic Ilizarov distraction assembly preoperatively. The modified assembly consisted of a pelvic component and halo ring, and distraction was given at the rate of 2-3 mm/day for 6-12 weeks. Complete clinical assessments along with pulmonary function tests were performed, and scoliosis series X-ray images were assessed for coronal and sagittal Cobb angle and other spinopelvic parameters before applying the assembly and during 2 years of follow-up.
RESULTS: Thirty-four patients (age, 9-27 years; male/female ratio of 18:16) were included. The coronal and sagittal Cobb angles were 116°±16.2° and 84°±28.3°, respectively. Correction rates obtained through modified halo-pelvic assembly were nearly 52% (p=0.001) in coronal and 40% (p=0.001) in sagittal Cobb angles, with improvement in height (p=0.001). Apical vertebral translation and coronal balance were also improved significantly (p=0.001). Further improvements in all the parameters were obtained after definitive surgery, with improvements in the forced expiratory volume in 1 second (p =0.002) and forced vital capacity (p=0.001).
CONCLUSIONS: Our modified halo-pelvic Ilizarov distraction assembly can achieve good correction in severe spinal deformities without significant risk to neurology, has fewer complications, and promotes good patient compliance.
摘要：
■一项为期2年的随访研究。
■评估改良的晕-骨盆Ilizarov牵引组件在治疗严重脊柱后凸患者中的有效性。
■严重和僵硬的脊柱侧凸曲线始终是手术外科医生的挑战。通过晕圈骨盆装置进行术前矫正成功地将曲线的严重程度降至最低；然而，其使用也报道了麻烦的并发症。修改后的组装对于这些情况可能是安全的。
■严重脊柱侧后凸(冠状Cobb角>90°)患者术前应用改良的晕圈-骨盆Ilizarov牵引组件。改进的组件由骨盆组件和光环环组成，以2-3毫米/天的速度给予牵引，持续6-12周。进行了完整的临床评估以及肺功能检查，和脊柱侧凸系列X线图像在应用装配前和随访2年期间评估冠状和矢状面Cobb角和其他脊柱骨盆参数。
■34名患者（年龄，9-27岁；男性/女性比例为18：16）。冠状和矢状Cobb角分别为116°±16.2°和84°±28.3°,分别。通过改良的晕圈骨盆组装获得的校正率在冠状面Cobb角中接近52％（p=0.001），在矢状Cobb角中接近40％（p=0.001）。随着身高的提高（p=0.001）。根尖椎体平移和冠状体平衡也显著改善(p=0.001)。在明确的手术后，所有参数都得到了进一步的改善，1秒用力呼气量（p=0.002）和用力肺活量（p=0.001）的改善。
■我们的改良光环-骨盆Ilizarov牵引组件可在严重的脊柱畸形中实现良好的矫正，而不会对神经病学产生重大风险，并发症少，并促进良好的患者依从性。
■评估改良的晕-骨盆Ilizarov牵引组件在治疗严重脊柱后凸患者中的有效性。
■严重和僵硬的脊柱侧凸曲线始终是手术外科医生的挑战。通过晕圈骨盆装置进行术前矫正成功地将曲线的严重程度降至最低；然而，其使用也报道了麻烦的并发症。修改后的组装对于这些情况可能是安全的。
■严重脊柱侧后凸(冠状Cobb角>90°)患者术前应用改良的晕圈-骨盆Ilizarov牵引组件。改进的组件由骨盆组件和光环环组成，以2-3毫米/天的速度给予牵引，持续6-12周。进行了完整的临床评估以及肺功能检查，和脊柱侧凸系列X线图像在应用装配前和随访2年期间评估冠状和矢状面Cobb角和其他脊柱骨盆参数。
■34名患者（年龄，9-27岁；男性/女性比例为18：16）。冠状和矢状Cobb角分别为116°±16.2°和84°±28.3°,分别。通过改良的晕圈骨盆组装获得的校正率在冠状面Cobb角中接近52％（p=0.001），在矢状Cobb角中接近40％（p=0.001）。随着身高的提高（p=0.001）。根尖椎体平移和冠状体平衡也显著改善(p=0.001)。在明确的手术后，所有参数都得到了进一步的改善，1秒用力呼气量（p=0.002）和用力肺活量（p=0.001）的改善。
■我们的改良光环-骨盆Ilizarov牵引组件可在严重的脊柱畸形中实现良好的矫正，而不会对神经病学产生重大风险，并发症少，并促进良好的患者依从性。
