흉강경을 이용한 척추측만증 수술에서의 굵은 강봉-다중축 나사못과 가는 강봉-단중축 나사못 비교 (Polyaxial Screws with Thick Rod versus Monoaxial Screws with Thin Rod in Video-Assisted Thoracoscopic Scoliosis Surgery(AVTS))

서지정보

· 발행기관 : 대한척추외과학회
· 수록지 정보 : 대한척추외과학회지 / 15권 / 1호 / 9 ~ 17페이지
· 저자명 : 김학선, 김주영, 박진오, 문성환, 이환모, 하중원, 문은수, 이수건, 위환, 김호중

초록

Study Design:Prospective controlled cohort studyObjective:To analyze the clinical outcome of video-assisted thoracoscopic surgery (VATS) between two different types ofimplants.Summary of Literature Review:The problem of correction loss has been reported with VATS, and different screws and rodshave been developed to overcome this problem. Different implants will have varying effects in correctional outcome afterVATS. Materials and Methods:A total of 39 cases of idiopathic adolescent scoliosis treated with VATS between June 2001 and Janu-ary 2005 were included in the study (mono-axial screws and a 4.5 mm rod: thin rod group=19 cases; poly-axial reductionscrews and a 5.5 mm diameter rod: thick rod group=20 cases). All patients were followed for over 2 years postoperatively. Forthe comparison of surgical outcomes between the two groups, radiographic measurements were performed in the coronal andsagittal planes. Results:Preoperative scoliosis angle (thin rod group 49.8。, thick rod group 47.1。), age, BMI, Risser stage, union time, operativetime, and blood loss showed no statistical difference between the two groups. Postoperative average correction rate of scoliosisangle was 69% (15.8。) in the thin rod group and 70% (14.1。) in the thick rod group. However, correction rate after 2 years was51% (24.5。) in the thin rod group and 60% (18.7。) in the thick rod group, showing statistically significant difference. There wasa tendency toward correction loss in the thin rod group (8.7。vs. 4.6。p=0.0057). Conclusion:Postoperative correction rate was satisfactory in both groups. However, the thin rod group showed substantial cor-rection loss. Therefore, poly-axial screws and thick rods are more suitable in VATS correction of scoliosis.

영어초록

Study Design:Prospective controlled cohort studyObjective:To analyze the clinical outcome of video-assisted thoracoscopic surgery (VATS) between two different types ofimplants.Summary of Literature Review:The problem of correction loss has been reported with VATS, and different screws and rodshave been developed to overcome this problem. Different implants will have varying effects in correctional outcome afterVATS. Materials and Methods:A total of 39 cases of idiopathic adolescent scoliosis treated with VATS between June 2001 and Janu-ary 2005 were included in the study (mono-axial screws and a 4.5 mm rod: thin rod group=19 cases; poly-axial reductionscrews and a 5.5 mm diameter rod: thick rod group=20 cases). All patients were followed for over 2 years postoperatively. Forthe comparison of surgical outcomes between the two groups, radiographic measurements were performed in the coronal andsagittal planes. Results:Preoperative scoliosis angle (thin rod group 49.8。, thick rod group 47.1。), age, BMI, Risser stage, union time, operativetime, and blood loss showed no statistical difference between the two groups. Postoperative average correction rate of scoliosisangle was 69% (15.8。) in the thin rod group and 70% (14.1。) in the thick rod group. However, correction rate after 2 years was51% (24.5。) in the thin rod group and 60% (18.7。) in the thick rod group, showing statistically significant difference. There wasa tendency toward correction loss in the thin rod group (8.7。vs. 4.6。p=0.0057). Conclusion:Postoperative correction rate was satisfactory in both groups. However, the thin rod group showed substantial cor-rection loss. Therefore, poly-axial screws and thick rods are more suitable in VATS correction of scoliosis.

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