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首页> 外文期刊>International Journal of General Medicine >Fourth-generation spinal instrumentation: experience with adolescent idiopathic scoliosis at a tertiary care hospital in Pakistan
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Fourth-generation spinal instrumentation: experience with adolescent idiopathic scoliosis at a tertiary care hospital in Pakistan

机译：第四代脊柱器械：在巴基斯坦的一家三级医院进行青少年特发性脊柱侧弯的经验

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Objective: To evaluate the radiological and functional outcome of surgical treatment of adolescent idiopathic scoliosis using fourth-generation posterior spinal instrumentation at The Aga Khan University, Karachi, Pakistan.Design: Case series.Place and duration of study: The Aga Khan University Hospital after a minimum of 2 years postoperatively.Patients and methods: A total of 20 patients with adolescent idiopathic scoliosis were recruited into the study and evaluated for radiological and functional outcome. The study period was from 2000 to 2005. Radiological outcome was assessed using Cobb angle measurement pre and postoperatively, hence assessing percentage correction. The lower instrumented vertebra was taken as the neutral vertebra and the level was recorded. Functional outcome was determined using the Scoliosis Research Society patient administered questionnaire. All patients were called to the clinic and asked to fill in the form. Those patients who were out of the city were mailed the forms and requested via telephone to complete and return.Results: Of the 20 patients operated on, twelve were female and eight were male. The average age at operation was 12.7 years. The mean Cobb angle was 69° preoperatively and 20° postoperatively, representing a percentage correction of 71%. The average duration of follow-up was 3.6 years. There was one major complication involving neurological injury post-op and two minor complications involving wound infection. The average Scoliosis Research Society score (on a scale of 1–5, with 5 being best) for pain was 4.5, self-image was 4.2, functional status was 4.1, mental status was 3.8, and satisfaction was 4.4. There was no relationship between the percentage correction of scoliosis and the functional outcome. Those patients with a high preoperative Cobb angle tended to have a better outcome for functional and mental status postoperatively. There was no relation between the lower instrumented vertebra and functional outcome.Conclusion: In the correct indications, fourth-generation posterior instrumentation and fusion is a reliable and satisfactory technique to treat adolescent idiopathic scoliosis.
机译：目的：通过巴基斯坦卡拉奇市阿加汗大学的第四代后路脊柱器械评估青少年特发性脊柱侧凸手术治疗的放射学和功能结局设计：病例系列研究的地点和持续时间：阿加汗大学医院患者和方法：总共招募了20例青少年特发性脊柱侧弯患者，并对其放射学和功能结局进行了评估。研究期间为2000年至2005年。放射学结果在手术前后均使用Cobb角测量仪进行了评估，从而评估了校正百分比。将下部器械化的椎骨作为中性椎骨并记录水平。使用脊柱侧弯研究协会患者问卷调查确定功能结局。所有患者都被叫到诊所，并要求填写表格。结果：在接受手术的20例患者中，有12例为女性，8例为男性。手术的平均年龄为12.7岁。术前平均Cobb角为69°，术后为20°，矫正百分比为71％。平均随访时间为3。6年。术后有1个主要并发症涉及神经系统损伤，还有2个较小的并发症涉及伤口感染。脊柱侧弯研究协会对疼痛的平均评分（1-5分，最高分5分），自我形象为4.2，功能状态为4.1，精神状态为3.8，满意度为4.4。脊柱侧弯的矫正百分比与功能结局之间没有关系。术前Cobb角高的患者术后功能和精神状态往往会更好。结论：在正确的适应症中，第四代后路椎体融合治疗是治疗青少年特发性脊柱侧弯的可靠且令人满意的技术。

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