흉강경을 이용한 측만증 교정술 후 척추 체 축상회전의 변화 (Changes in Vertebral Axial Rotationafter Thoracoscopic Scoliosis Correction)

서지정보

· 발행기관 : 대한정형외과학회
· 수록지 정보 : 대한정형외과학회지 / 43권 / 5호 / 567 ~ 571페이지
· 저자명 : 오성균, 정성수, 강창석, 김연상, 곽봉준, 이종서

초록

Purpose: In this study, we investigated whether thoracoscopic anterior correction can effectively derotates the scoliotic spine and we also evaluated the patterns of derotational changes inside the instrumented area and at the junction between the instrumented and uninstrumented area.
Materials and Methods: Preoperative and postoperative MR images with single axial cuts through each vertebral level were obtained in 20 patients who underwent thoracoscopic anterior instrumentation. Each vertebral rotation was measured by the use of Aaro's method. Vertebral axial derotation of the apical zone (AZ), upper instrumented zone (UIZ), lower instrumented zone (LIZ) and junctional segment were compared. The amount of segmental rotation and segmental derotation in each zone was calculated. Statistical analysis was performed by the use of by 2-way ANOVA and the Wilcoxon signed ranks test.
Results: The average axial rotations at AZ were 10.1o preoperatively and 5.3o postoperatively with an average correction rate of 48%. Derotation of the AZ was greater than the UIZ and LIZ. For the LIZ derotation was not significant (p=0.023) while for the UIZ there was a significant derotation (p＜0.001). Postoperatively, the first uninstrumented vertebra rotated significantly in the direction of rotation of the instrumented end vertebra. Preoperative and postoperative segmental rotation was higher in the UIZ and LIZ than in the AZ. However, segmental derotation occurred uniformly in the instrumented area. At the junctional segment, preoperative segmental rotation was same as that of the UIZ and LIZ and segmental derotation was not significant.
Conclusion: Thoracoscopic scoliosis correction can achieve effective axial correction by causing derotation of each of the vertebral bodies and segmental derotation.

영어초록

Purpose: In this study, we investigated whether thoracoscopic anterior correction can effectively derotates the scoliotic spine and we also evaluated the patterns of derotational changes inside the instrumented area and at the junction between the instrumented and uninstrumented area.
Materials and Methods: Preoperative and postoperative MR images with single axial cuts through each vertebral level were obtained in 20 patients who underwent thoracoscopic anterior instrumentation. Each vertebral rotation was measured by the use of Aaro's method. Vertebral axial derotation of the apical zone (AZ), upper instrumented zone (UIZ), lower instrumented zone (LIZ) and junctional segment were compared. The amount of segmental rotation and segmental derotation in each zone was calculated. Statistical analysis was performed by the use of by 2-way ANOVA and the Wilcoxon signed ranks test.
Results: The average axial rotations at AZ were 10.1o preoperatively and 5.3o postoperatively with an average correction rate of 48%. Derotation of the AZ was greater than the UIZ and LIZ. For the LIZ derotation was not significant (p=0.023) while for the UIZ there was a significant derotation (p＜0.001). Postoperatively, the first uninstrumented vertebra rotated significantly in the direction of rotation of the instrumented end vertebra. Preoperative and postoperative segmental rotation was higher in the UIZ and LIZ than in the AZ. However, segmental derotation occurred uniformly in the instrumented area. At the junctional segment, preoperative segmental rotation was same as that of the UIZ and LIZ and segmental derotation was not significant.
Conclusion: Thoracoscopic scoliosis correction can achieve effective axial correction by causing derotation of each of the vertebral bodies and segmental derotation.

참고자료

· 없음