UNASSIGNED:我们介绍了神经肌肉侧凸的椎旁入路,重点是畸形矫正,最小随访时间为2年的围手术期(≤30天)发病率和结局。
UNASSIGNED:我们前瞻性收集了2013年至2019年间使用椎旁(Wiltse)方法手术的61名神经肌肉脊柱侧凸患者的数据。我们还收集了104例对照病例的数据,在2005年至2016年期间使用中线方法运营。15Wiltse,由于随访时间短(<2年),分别有37例对照患者被排除在外,22名对照组因缺乏随访数据而被排除.因此,比较了46例Wiltse和45例对照患者。
未经评估:Wiltse和对照组患者的随访时间相当,人口统计,畸形矫正,并发症发生率,融合的级别数,重症监护室和住院时间。Wiltse病例的估计失血量较低(535对1187mL;p值<0.001),同种异体输血率(48%vs96%;p值<0.001),和操作时间(ORT)(337比428分钟;p值<0.001)比对照组。选择没有骨盆固定的患者时也是如此(p值<0.001)。选择骨盆固定术的病例(91例中20例),根据该方法,仅融合水平和ORT的数量显着不同(p值<0.015和<0.041)。
UNASSIGNED:椎旁神经肌肉侧凸的方法是安全的,与显著的畸形矫正相关,减少估计失血量,和同种异体输血率。这些潜在的好处仍然需要评估,尤其是骨盆固定的病例,进一步随访更大的队列。
未经批准:三级。
UNASSIGNED: We present the paraspinal approach use for neuromuscular scoliosis with focus on deformity correction, perioperative (≤30 days) morbidity and outcome at a minimal follow-up length of 2 years.
UNASSIGNED: We prospectively collected data of 61 neuromuscular scoliosis patients operated using a paraspinal (Wiltse) approach between 2013 and 2019. We additionally collected data of 104 control cases, operated using a midline approach between 2005 and 2016. Fifteen Wiltse, respectively 37 control patients were excluded due to a short follow-up (<2 years), and 22 controls were excluded secondary to lacking follow-up data. Hence, 46 Wiltse and 45 control patients were compared.
UNASSIGNED: Wiltse and control patients had comparable follow-up lengths, demographics, deformity corrections, complication rates, number of levels fused, and intensive care unit and hospital lengths of stay. Wiltse cases had a lower estimated blood loss (535 vs 1187 mL; p-value < 0.001), allogenic transfusion rate (48% vs 96%; p-value < 0.001), and operating time (ORT) (337 vs 428 min; p-value < 0.001) than controls. This was also the case when selecting for patients without pelvic fixation (p-values < 0.001). When selecting the cases with pelvic fixation (20 among 91 cases), only the number of levels fused and the ORT differed significantly according to the approach (p-value <0.015 and <0.041).
UNASSIGNED: The paraspinal approach for neuromuscular scoliosis is safe, associated with significant deformity correction, reduced estimated blood loss, and allogenic transfusion rate. These potential benefits still need to be evaluated, especially for cases with pelvic fixation, with further follow-up of larger cohorts.
UNASSIGNED: level III.