背景与目的:青少年特发性脊柱侧凸(AIS)是一种普遍存在的三维脊柱疾患,具有多因素的发病机理,包括遗传学和环境因素。治疗选择包括非手术和手术治疗。手术干预在畸形矫正方面显示出积极的结果,疼痛缓解,和改善心脏和肺功能。手术并发症,包括过度失血和神经功能缺损,在2.27-12%的病例中报告。导航辅助技术,比如O形臂系统,一直是最近的焦点,精度更高。本研究旨在评估O形臂导航辅助下AIS患者一期后路器械融合的结果和并发症。材料和方法:这项回顾性研究评估了55例AIS患者(12-28岁),他们在2016年6月至2023年8月期间接受了由O-arm导航支持的一期后方器械矫正。我们检查了放射学手术结果(初始矫正率,校正率损失,最后一次随访纠正率)和并发症作为主要结果。患者的特点,术中失血,操作时间,融合水平的数量,并记录了螺杆密度。结果:73例患者中,55符合纳入标准。平均年龄16.67岁,以女性为主(78.2%)。手术结果显示出实质性的初始校正(58.88%)和在最后一次随访中持续的积极放射学影响(56.56%)。围手术期并发症,包括主要和次要,发生在18.18%的病例中。两名患者经历了严重的并发症。失血量(509.46mL)和手术时间(402.13min)与文献范围相当。趋势分析表明,在研究期间,手术时间和失血量有所改善。结论:O形臂导航辅助的一期后路器械对于AIS矫正手术证明是可靠的,实现显著和持续的积极放射学结果,更低的校正损失,减少术中失血,和没有植入物相关的并发症。尽管面临挑战,我们的研究证明了这种手术方法的有效性和成熟度.
Background and Objectives: Adolescent idiopathic scoliosis (AIS) is a prevalent three-dimensional spinal disorder, with a multifactorial pathogenesis, including genetics and environmental aspects. Treatment options include non-surgical and surgical treatment. Surgical interventions demonstrate positive outcomes in terms of deformity correction, pain relief, and improvements of the cardiac and pulmonary function. Surgical complications, including excessive blood loss and neurologic deficits, are reported in 2.27-12% of cases.
Navigation-assisted techniques, such as the O-arm system, have been a recent focus with enhanced precision. This study aims to evaluate the results and complications of one-stage posterior instrumentation fusion in AIS patients assisted by O-arm
navigation. Materials and Methods: This retrospective study assesses 55 patients with AIS (12-28 years) who underwent one-stage posterior instrumentation correction supported by O-arm
navigation from June 2016 to August 2023. We examined radiological surgical outcomes (initial correction rate, loss of correction rate, last follow-up correction rate) and complications as major outcomes. The characteristics of the patients, intraoperative blood loss, operation time, number of fusion levels, and screw density were documented. Results: Of 73 patients, 55 met the inclusion criteria. The average age was 16.67 years, with a predominance of females (78.2%). The surgical outcomes demonstrated substantial initial correction (58.88%) and sustained positive radiological impact at the last follow-up (56.56%). Perioperative complications, including major and minor, occurred in 18.18% of the cases. Two patients experienced a major complication. Blood loss (509.46 mL) and operation time (402.13 min) were comparable to the literature ranges. Trend analysis indicated improvements in operation time and blood loss over the study period. Conclusions: O-arm
navigation-assisted one-stage posterior instrumentation proves reliable for AIS corrective surgery, achieving significant and sustained positive radiological outcomes, lower correction loss, reduced intraoperative blood loss, and absence of implant-related complications. Despite the challenges, our study demonstrates the efficacy and maturation of this surgical approach.