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- 저자 : Shengru Wang (검색결과 3 건)
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Shengru Wang,Jianguo Zhang,Yanbin Zhang,You Du,Yang Yang,Guanfeng Lin 대한척추신경외과학회 2021 Neurospine Vol.18 No.3
Objective: To introduce surgical strategies to restore coronal balance during limited fusion for early lumbar hemivertebra resection in patients with severe sacral tilt. Methods: Sacral tilt was defined as a sacral tilt angle ≥5, and severe sacral tilt was defined as a sacral tilt angle >10. From July 2004 to December 2017, 73 consecutive patients treated with posterior hemivertebra resection and short fusion in our institution were evaluated. Severe sacral tilt was noted in 26 patients (14 boys and 12 girls), and all were enrolled in this study. Undercorrection of the primary lumbar curve as compensation for the sacral tilt and short fusion was performed in these patients. The medical charts and imaging data of the patients were retrospectively reviewed to evaluate the outcomes. Results: All patients were followed for at least 2 years. The mean age at the time of surgery was 3.7 (2–9) years old, with a total of 31 lumbar hemivertebra excised. On average, 2.8 (2–5) segments were fused for each patient. Sacral tilt minimally improved from 14.5° preoperatively to 13.6° postoperatively (p=0.15) and remained stable at the follow-up. The overall lumbar curve was 41.9° preoperatively, 11.7° immediately postoperatively, and 14.6° at the final follow-up. The segmental scoliosis curve was 39.1° preoperatively, 9.7° immediately postoperatively, and 11.2° at the final follow-up. Segmental kyphosis was corrected from 27.2° to 6.5° after the surgery and was 7.1° at the latest follow-up. Conclusion: Sacral tilt is seen in patients with congenital scoliosis in lumbar hemivertebra. Undercorrection of the lumbar curve and segmental scoliosis to compensate for sacral tilt and short fusion after hemivertebra resection may be helpful to restore coronal balance and preserve mobility in segments in patients with pronounced severe sacral tilt.
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Shengru Wang,Yiwei Zhao,Guanfeng Lin,You Du,Yang Yang,Jianguo Zhang 대한척추신경외과학회 2023 Neurospine Vol.20 No.3
Objective: Based on traditional dual growing rods (TDGR), apical control techniques (ACTs) were introduced as adjuvant procedures to improve deformity correction at the apex segment in the treatment of early-onset scoliosis (EOS). We aimed to explore whether TDGR+ ACTs have different indications, attain more deformity correction, have negative effects on spinal growth, and have different complications. Methods: Between 2004 and 2019, a retrospective study of EOS patients treated with TDGR with or without ACTs was conducted and divided into 3 groups: TDGR group; hybrid technique (HT) group: Vertebrectomy/hemivertebrectomy with short fusion and TDGR; ACPS group: apical convex control pedicle screws (ACPS) and TDGR. Demographic, radiographic parameters, clinical outcomes, complications, and revisions were analyzed and compared. Results: Seventy-eight EOS patients were enrolled. The preoperative main curve was the largest in the HT group. ACPS group had the smallest residual curve (19° ± 8.9°) and apical vertebral translation (12.0 ± 9.0 mm) at the latest follow-up, followed by the HT group (30° ± 17.4°, 22.1 ± 13.4 mm) and TDGR group (30° ± 13.2°, 32.8 ± 17.1 mm). ACPS group had the largest T1–12 height and T1–S1 height after index surgery. Complications and revisions in the ACTs groups was lower than the TDGR group. Scoliosis Research Society-22 self-image questionnaire was superior in the ACPS group. Conclusion: According to our intermediate results, TDGR+ACTs could improve correction ability of apex deformity. ACTs had little deleterious effects on spinal height during the lengthening procedures, with a lower complication rate than TDGR. TDGR+ACTs might be a supplemental option for suitable EOS patients.
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Zhiyi Li,You Du,Yiwei Zhao,Guanfeng Lin,Haoran Zhang,Chenkai Li,Xiaohan Ye,Yang Yang,Shengru Wang,Jianguo Zhang 대한척추신경외과학회 2023 Neurospine Vol.20 No.4
Objective: To compare the radiological outcomes in Lenke 5C type patients whose lowest instrumented vertebra (LIV) was L3 or L4 in a case-match study. Methods: We conducted a retrospective case-match study and included 82 patients in the study. Radiological results before surgery, after surgery, and at last follow-up were recorded and analyzed in the L3 and L4 groups. Results: After matching the age, Risser’s sign, sex, and main Cobb, 41 pairs of patients were enrolled in our study. The total fusion segments in the L3 group (median [interquartile range]: 5.0 [6.0–5.0]) were shorter than those in the L4 group (6.0 [6.5–6.0]). The main curve was significantly corrected after surgery in both groups, and was comparable at the last followup between groups. In addition, according to the results of Fisher precision probability test, there was no significant difference of coronal or sagittal imbalance between the 2 groups at the 2-year follow-up. Conclusion: The correction in coronal and sagittal planes in L3 group and L4 group remains similar. On account of more motion segments, L3 could be an ideal choice as LIV in moderate Lenke 5C type AIS. Long-term follow-up is needed to evaluate the effect of larger compensatory lumbar-sacral curve when stopping at L3.
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