Objective: To evaluate the radiographic and clinical outcomes of sequential correction based on satellite rod technique in degenerative scoliosis (DS) with B-type coronal imbalance, and to investigate the efficacy of sequential correction in this cohort. Methods: Twenty-one DS patients with B-type coronal imbalance applying sequential correction from December 2015 to July 2017 in Nanjing Drum Tower Hospital were retrospectively reviewed. There were 4 males and 17 females in this group, the average age was (63±8) years. The coronal parameters including Cobb angle of main curve and distance between C(7) plumb line and center sacral vertical line (C(7)PL-CSVL), as well as sagittal parameters including global kyphosis (GK) and sagittal vertical axis (SVA) were assessed pre-operatively, post-operatively and at the last follow-up. The Scoliosis Research Society-22 (SRS-22) questionnaire was fulfilled before the operation and at each follow-up to evaluate the quality of life. Paired t test was performed for statistical analysis. Results: The patients were followed-up for (20±8) months. The post-operative Cobb angle of main curve was significantly improved from 52°±12° to 19°±7° (t=13.886, P<0.01), and it was 19°±8° at the last follow-up and no significant correction loss was attained (t=1.101, P=0.284). The values of C(7)PL-CSVL before the operation, after the operation and at the final follow-up were (46±11) mm, (12±7) mm and (12±7) mm, respectively; significant post-operative improvement achieved (t=19.718, P<0.01) while there was no correction loss at last follow-up (t=-1.393, P=0.179). After sequential correction, 20 patients (95.2%) improved to A-type coronal imbalance while 1 patient (4.8%) remained with B-type coronal imbalance. Significant post-operative improvements were found in terms of GK and SVA and no significant correction loss was found during follow-up. The scores of pain and self-image showed significant improvement at the last follow-up (t=8.706, 3.104, both P<0.01). In addition, there was no implant failure during follow-up. Conclusion: The sequential correction based on satellite rod technique in DS patients with B-type coronal imbalance corrects the deformity, relieves the clinical symptoms, improves the quality of life, and decreases the rates of post-operative coronal imbalance as well as implant-related complications.
目的： 探讨基于卫星棒技术的序贯矫形在伴有B型冠状面失衡的退变性脊柱侧凸（DS）患者中的临床疗效，并评估序贯矫形在该类患者中的应用价值。 方法： 回顾性分析2015年12月至2017年7月于南京鼓楼医院应用序贯矫形技术行手术治疗的21例伴有B型冠状面失衡的DS患者的临床资料。患者男4例，女17例，平均年龄（63±8）岁。测量术前、术后及末次随访时的主弯Cobb角、冠状面平衡（C(7)PL-CSVL）、最大后凸Cobb角（GK）和矢状面平衡（SVA）等影像学参数。患者术前及每次随访时均填写脊柱侧凸研究学会-22问卷（SRS-22）以评估生活质量。手术前后比较分析应用配对t检验。 结果： 本组平均随访（20±8）个月。主弯侧凸Cobb角由术前52°±12°改善至术后19°±7°（t=13.886，P<0.01），末次随访时为19°±8°，未见明显矫正丢失（t=1.101，P=0.284）。术前C(7)PL-CSVL为（46±11）mm，术后减至（12±7）mm（t=19.718，P<0.01），末次随访时为（12±7）mm，与术后相比差异无统计学意义（t=-1.393，P=0.179）。术后GK及SVA均较术前有明显改善，随访时未见明显矫正丢失。末次随访时20例（95.2%）患者冠状面平衡类型改善至A型，1例（4.8%）仍为B型。末次随访时SRS-22量表疼痛及自我形象评分与术前相比差异均有统计学意义（t=8.706、3.104，均P<0.01）。所有患者随访期间均未出现内固定相关并发症。 结论： 对伴有B型冠状面失衡的DS患者应用基于卫星棒技术的序贯矫形可明显改善患者外观畸形和临床症状、提高其生活质量、降低术后冠状面失衡及内固定失败等并发症风险。.
Keywords: B-type coronal imbalance; Degenerative scoliosis; Satellite rod; Sequential correction.