Scoliosis fixation system implantation and the application of three-dimensional reconstruction technique

背景：脊柱侧弯是一种复杂的三维平面的畸形，包括冠状上的侧方弯曲，矢状面上生理前、后凸的减少或增大，轴向面上脊柱的旋转畸形，充分减压，最大限度重建脊柱在冠状面和失状面的平衡，长节段固定、短节段融合的方法是退变性脊柱侧弯较理想的矫形方法。目的：分析脊柱侧弯内固定系统的特点。方法：第一作者应用计算机检索1999至2015年 PubMed 数据库、中国期刊全文数据库有关脊柱侧弯内固定系统的文章，英文检索词“scoliosis，internal fixation，three-dimensional correction”；中文检索词“脊柱侧弯，内固定，三维重建”。共检索到163篇相关文献，34篇文献符合纳入标准。结果与结论：随着内固定材料的发展，根据脊柱三维矫形概念设计的脊柱内固定系统是一个动态发展的系统，目标是尽可能在三维上全面恢复脊柱的平衡，目前应用很广泛的通用型脊柱内固定系统包括 TSRH 脊柱内固定系统、ISOLA 脊柱内固定系统、Moss Miami 脊柱内固定系统、CD Horizon 脊柱内固定系统和中华长城脊柱内固定系统，脊柱内固定系统具有三维矫形能力，能很好地矫正脊柱冠状和矢状面的畸形，生物力学合理，固定可靠。骨移植材料是防止内固定物断裂、螺钉拔出等并发症发生的关键因素，人工骨与自体骨、同种异体骨、异种骨作植骨材料相比，可以缩短矫形时间及减少因植骨而并发传染病的风险，是未来植骨材料的趋势。同时三维重建已应用于临床实践，可为脊柱侧弯矫形治疗制定方案，为保证内固定物的安全性提供影像学参考，对提高脊柱内固定系统的综合疗效起到巨大的作用。BACKGROUND: Scoliosis is a complex three-dimensional plane deformity, including lateral bending on the coronal plane, before physiological kyphosis reduction or increase in the sagittal plane, the rotational deformity of the spine in the axial plane. The method of ful decompression, maximum reconstruction of spinal balance in coronal and sagittal plane, long-segmental fixation and short-segmental fusion is the more ideal orthopedic method for degenerative scoliosis. OBJECTIVE: To analyze the characteristics of scoliosis fixation system. METHODS: The articles about scoliosis fixation system were retrieved from PubMed database, Chinese Journal Ful -text database from 1999 to 2015 by the first author using computer. “Scoliosis, Internal Fixation, Three-dimensional Correction” were taken as the search terms in English and Chinese. Total y 163 relevant articles were retrieved, and eventual y 34 articles met the inclusion criteria. RESULTS AND CONCLUSION: With the development of fixation materials, the spinal fixation system which was designed based on three-dimensional orthopedic concept of spine is a dynamical y developed system. The goal is to restore the balance of spine in three dimensions as comprehensive as possible. At present, the general spinal system within very broad application includes TSRH spinal fixation system, ISOLA spinal internal fixation system, Moss Miami spinal fixation system, CD Horizon spinal internal system and China Great Wal spinal fixation system. Spinal fixation system possesses three-dimensional orthopedic capability, and can correct the spinal deformity in coronal and sagittal plane, and biomechanics is reasonable, fixed and reliable. Bone grafting material is the key factor of preventing breakage of internal fixation, screw extraction and other complications. Compared with such bone grafting materials made of autologous bone, al ograft bone and xenograft bone, artificial bone can shorten the orthopedic time and reduce the risk of concurrent diseases because of bone grafting, which is the future trend of bone grafting material. Meanwhile, three-dimensional reconstruction has been used in clinical practice, and can develop programs for scoliosis orthopedic treatment, provide imaging reference to ensure the security of internal fixation and also has played a huge role in improving the comprehensive efficacy of spinal internal fixation system.中国科技核心期刊(ISTIC)4583-5882