Lenke 1型青少年特发性脊柱侧凸选择性融合的研究进展_West China Medical Journal

Authors：

 林书 ,  宋跃明

四川大学华西医院骨科（成都，610041）;

Corresponding author：

宋跃明, Email: sym_cd@yahoo.com.cn

Keywords：

青少年脊柱侧凸; 选择形融合; Lenke 1型; 上端融合椎; 下端融合椎

DOI：

10.7507/1002-0179.20140110

Video：

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Lenke 1型青少年脊柱侧凸是脊柱侧凸最常见的类型。随着三维矫形的进步，特别是椎弓根螺钉的广泛应用，Lenke 1型青少年特发性脊柱侧凸选择性融合的适应标准和末端融合椎的选择策略有了更新的认识，但目前尚无标准化的治疗方案。现就以上内容作一综述。

Citation： 林书, 宋跃明. Lenke 1型青少年特发性脊柱侧凸选择性融合的研究进展. West China Medical Journal, 2014, 29(2): 356-360. doi: 10.7507/1002-0179.20140110 Copy

1.	Danielsson AJ,Cederlund CG,Ekholm S,et al.The prevalence of disc aging and back pain after fusion extending into the lower lumbar spine.A matched MR study twenty-five years after surgery for adolescent idiopathic scoliosis[J].Acta Radiol,2001,42(2):187-197.
2.	Cochran T,Irstam L,Nachemson A.Long-term anatomic and functional changes in patients with adolescent idiopathic scoliosis treated by Harrington rod fusion[J].Spine (Phila Pa 1976),1983,8(6):576-584.
3.	Edgar MA,Mehta MH.Long-term follow-up of fused and unfused idiopathic scoliosis[J].J Bone Joint Surg,1998,70(5):712-716.
4.	Lenke LG,Betz RR,Harms J,et al.Adolescent idiopathic scoliosis:a new classification to determine extent of spinal arthrodesis[J].J Bone Joint Surg Am,2001,83-A (8):1169-1181.
5.	Lenke LG,Bridwell KH,Baldus C,et al.Preventing decompensation in King type Ⅱ curves treated with Cotrel-Dubousset instrumentation.Strict guidelines for selective thoracic fusion[J].Spine (Phila Pa 1976),1992,17(8 Suppl):274-281.
6.	Edwards CC,Lenke LG,Peelle M,et al.Selective thoracic fusion for adolescent idiopathic scoliosis with C modifier lumbar curves:2-to 16-year radiographic and clinical results[J].Spine (Phila Pa 1976),2004,29(5):536-546.
7.	Demura S,Yaszay B,Bastrom TP,et al.Is decompensation preoperatively a risk in Lenke 1C curves?[J].Spine (Phila Pa 1976),2013,38(11):E649-E655.
8.	Chang KW,Chang KI,Wu CM.Enhanced capacity for spontaneous correction of lumbar curve in the treatment of major thoracic-compensatory C modifier lumbar curve pattern in idiopathic scoliosis[J].Spine (Phila Pa 1976),2007,32(26):3020-3029.
9.	仇建国,邱贵兴,王以朋,等.青少年特发性脊柱侧凸的选择性胸椎融合治疗[J].中华外科杂志,2004,42(4):216-219.
10.	邱勇,曹兴兵,钱邦平,等.内固定方式对青少年特发性脊柱侧凸选择性胸椎融合矢状面重建的影响[J].中华骨科杂志,2010,30(6):569-574.
11.	Newton PO,Upasani VV,Bastrom TP,et al.The deformity-flexibility quotient predicts both patient satisfaction and surgeon preference in the treatment of Lenke 1B or 1C curves for adolescent idiopathic scoliosis[J].Spine (Phila Pa 1976),2009,34(10):1032-1039.
12.	Lowe TG,Lenke L,Betz R,et al.Distal junctional kyphosis of adolescent idiopathic thoracic curves following anterior or posterior instrumented fusion:incidence,risk factors,and prevention[J].Spine (Phila Pa 1976),2006,31(3):299-302.
13.	Patel PN,Upasani VV,Bastrom TP,et al.Spontaneous lumbar curve correction in selective thoracic fusions of idiopathic scoliosis:a comparison of anterior and posterior approaches[J].Spine (Phila Pa 1976),2008,33(10):1068-1073.
14.	Kuklo TR,Lenke LG,Graham EJ,et al.Correlation of radiographic,clinical,and patient assessment of shoulder balance following fusion versus nonfusion of the proximal thoracic curve in adolescent idiopathic scoliosis[J].Spine (Phila Pa 1976),2002,27(18):2013-2020.
15.	贾惊宇,孙英伟,张立军.特发性脊柱侧凸患者两侧椎旁肌横截面积的CT测量[J].中国脊柱脊髓杂志,2009,19(3):208-211.
16.	吴亮,邱勇,王斌,等.脊柱侧凸椎旁肌肌纤维不对称性分布的研究[J].脊柱外科杂志,2004,2(5):276-279.
17.	孙旭,邱勇,孙超.Lenke 1A型脊柱侧凸选择性胸弯融合术后远端叠加现象及其危险因素[C]//第四届中华骨科杂志论坛文集.天津:中华骨科杂志编辑部,2012:177-181.
18.	Chang KW,Leng X,Zhao W,et al.Broader curve criteria for selective thoracic fusion[J].Spine (Phila Pa 1976),2011,36(20):1658-1664.
19.	Harrington PR.Treatment of scoliosis.Correction and internal fixation by spine instrumentation[J].J Bone Joint Surg Am,1962,44-A (4):591-610.
20.	Moe JH.A critical analysis of methods of fusion for scoliosis:an evaluation in two hundred and sixty-six patients.1958[J].Clin Orthop Relat Res,2007,460(3):21-28.
21.	Tambornino JM,Armbrust EN,Moe JH.Harrington instrumentation in correction of scoliosis.A comparison with cast correction[J].J Bone Joint Surg Am,1964,46(2):313-321.
22.	King HA.Selection of fusion levels for posterior instrumentation and fusion in idiopathic scoliosis[J].Orthop Chin North Am,1988,19(2):247-255.
23.	Kim YJ,Lenke LG,Cho SK,et al.Comparative analysis of pedicle screw versus hook instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis[J].Spine (Phila Pa 1976),2004,29(18):2040-2048.
24.	Suk SI,Lee SM,Chung ER,et al.Selective thoracic fusion with segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis:more than 5-year follow-up[J].Spine (Phila Pa 1976),2005,30(14):1602-1609.
25.	Dobbs MB,Lenke LG,Kim YJ,et al.Selective posterior thoracic fusions for adolescent idiopathic scoliosis:comparison of hooks versus pedicle screws[J].Spine (Phila Pa 1976),2006,31(20):2400-2404.
26.	Suk SI,Lee SM,Chung ER,et al.Determination of distal fusion level with segmental pedicle screw fixation in single thoracic idiopathic scoliosis[J].Spine (Phila Pa 1976),2003,28(5):484-491.
27.	张宏志,张永刚,张雪松,等.后路选择性融合治疗青少年特发性脊柱侧凸单胸弯[J].中华医学杂志,2007,87(9):599-601.
28.	Takahashi J,Newton PO,Ugrinow VL,et al.Selective thoracic fusion in adolescent idiopathic scoliosis:factors influencing the selection of the optimal lowest instrumented vertebra[J].Spine (Phila Pa 1976),2011,36(14):1131-1141.
29.	Jansen RC,van Rhijn LW,Duinkerke E,et al.Predictability of the spontaneous lumbar curve correction after selective thoracic fusion in idiopathic scoliosis[J].Eur Spine J,2007,16(9):1335-1342.
30.	Thompson JP,Transfeldt EE,Bradford DS,et al.Decompensation after Cotrel-Dubousset instrumentation of idiopathic scoliosis[J].Spine (Phila Pa 1976),1990,15(9):927-931.
31.	Lee SM,Suk SI,Chung ER.Direct vertebral rotation:a new technique of three-dimensional deformity correction with segmental pedicle screw fixation in adolescent idiopathic scoliosis[J].Spine (Phila Pa 1976),2004,29(3):343-349.
32.	Potter BK,Kuklo TR,Lenke LG.Radiographic outcomes of anterior spinal fusion versus posterior spinal fusion with thoracic pedicle screws for treatment of Lenke TypeⅠ adolescent idiopathic scoliosis curves[J].Spine (Phila Pa 1976),2005,30(16):1859-1866.
33.	刘臻,邱勇.朱泽章.Lenke 1型特发性脊柱侧凸选择性胸弯融合时的下端融合椎选择:T12还是L1?[J].中国矫形外科杂志,2012,20(21):1921-1925.
34.	Tao F,Shi Z,Xie Y,et al.Determination of lowest instrumented vertebra by the location of apical vertebra in Lenke type 1 adolescent idiopathic scoliosis[J].Int Orthop,2011,35(4):561-567.
35.	Miyanji F,Pawelek JB,Van Valin SE,et al.Is the lumbar modifier useful in surgical decision making? Defining two distinct Lenke 1A curve patterns[J].Spine (Phila Pa 1976),2008,33(23):2545-2551.
36.	Cil A,Pekmezci M,Yazici M,et al.The validity of Lenke criteria for defining structural proximal thoracic curves in patients with adolescent idiopathic scoliosis[J].Spine (Phila Pa 1976),2005,30(22):2550-2555.
37.	Suk SI,Kim WJ,Kim JH,et al.Indications of proximal thoracic curve fusion in thoracic adolescent idiopathic scoliosis:recognition and treatment of double thoracic curve pattern in adolescent idiopathic scoliosis treated with segmental instrumentation[J].Spine (Phila Pa 1976),2000,25(18):2342-2349.
38.	Rose PS,Lenke LG.Classification of operative adolescent idiopathic scoliosis:treatment guidelines[J].Orthop Clin North Am,2007,38(4):521-529.
39.	Ilharreborde B,Even J,Lefevre Y,et al.How to determine the upper level of instrumentation in Lenke types 1 and 2 adolescent idiopathic scoliosis:a prospective study of 132 patients[J].J Pediatr Orthop,2008,28(7):733-739.

1. Danielsson AJ,Cederlund CG,Ekholm S,et al.The prevalence of disc aging and back pain after fusion extending into the lower lumbar spine.A matched MR study twenty-five years after surgery for adolescent idiopathic scoliosis[J].Acta Radiol,2001,42(2):187-197.
2. Cochran T,Irstam L,Nachemson A.Long-term anatomic and functional changes in patients with adolescent idiopathic scoliosis treated by Harrington rod fusion[J].Spine (Phila Pa 1976),1983,8(6):576-584.
3. Edgar MA,Mehta MH.Long-term follow-up of fused and unfused idiopathic scoliosis[J].J Bone Joint Surg,1998,70(5):712-716.
4. Lenke LG,Betz RR,Harms J,et al.Adolescent idiopathic scoliosis:a new classification to determine extent of spinal arthrodesis[J].J Bone Joint Surg Am,2001,83-A (8):1169-1181.
5. Lenke LG,Bridwell KH,Baldus C,et al.Preventing decompensation in King type Ⅱ curves treated with Cotrel-Dubousset instrumentation.Strict guidelines for selective thoracic fusion[J].Spine (Phila Pa 1976),1992,17(8 Suppl):274-281.
6. Edwards CC,Lenke LG,Peelle M,et al.Selective thoracic fusion for adolescent idiopathic scoliosis with C modifier lumbar curves:2-to 16-year radiographic and clinical results[J].Spine (Phila Pa 1976),2004,29(5):536-546.
7. Demura S,Yaszay B,Bastrom TP,et al.Is decompensation preoperatively a risk in Lenke 1C curves?[J].Spine (Phila Pa 1976),2013,38(11):E649-E655.
8. Chang KW,Chang KI,Wu CM.Enhanced capacity for spontaneous correction of lumbar curve in the treatment of major thoracic-compensatory C modifier lumbar curve pattern in idiopathic scoliosis[J].Spine (Phila Pa 1976),2007,32(26):3020-3029.
9. 仇建国,邱贵兴,王以朋,等.青少年特发性脊柱侧凸的选择性胸椎融合治疗[J].中华外科杂志,2004,42(4):216-219.
10. 邱勇,曹兴兵,钱邦平,等.内固定方式对青少年特发性脊柱侧凸选择性胸椎融合矢状面重建的影响[J].中华骨科杂志,2010,30(6):569-574.
11. Newton PO,Upasani VV,Bastrom TP,et al.The deformity-flexibility quotient predicts both patient satisfaction and surgeon preference in the treatment of Lenke 1B or 1C curves for adolescent idiopathic scoliosis[J].Spine (Phila Pa 1976),2009,34(10):1032-1039.
12. Lowe TG,Lenke L,Betz R,et al.Distal junctional kyphosis of adolescent idiopathic thoracic curves following anterior or posterior instrumented fusion:incidence,risk factors,and prevention[J].Spine (Phila Pa 1976),2006,31(3):299-302.
13. Patel PN,Upasani VV,Bastrom TP,et al.Spontaneous lumbar curve correction in selective thoracic fusions of idiopathic scoliosis:a comparison of anterior and posterior approaches[J].Spine (Phila Pa 1976),2008,33(10):1068-1073.
14. Kuklo TR,Lenke LG,Graham EJ,et al.Correlation of radiographic,clinical,and patient assessment of shoulder balance following fusion versus nonfusion of the proximal thoracic curve in adolescent idiopathic scoliosis[J].Spine (Phila Pa 1976),2002,27(18):2013-2020.
15. 贾惊宇,孙英伟,张立军.特发性脊柱侧凸患者两侧椎旁肌横截面积的CT测量[J].中国脊柱脊髓杂志,2009,19(3):208-211.
16. 吴亮,邱勇,王斌,等.脊柱侧凸椎旁肌肌纤维不对称性分布的研究[J].脊柱外科杂志,2004,2(5):276-279.
17. 孙旭,邱勇,孙超.Lenke 1A型脊柱侧凸选择性胸弯融合术后远端叠加现象及其危险因素[C]//第四届中华骨科杂志论坛文集.天津:中华骨科杂志编辑部,2012:177-181.
18. Chang KW,Leng X,Zhao W,et al.Broader curve criteria for selective thoracic fusion[J].Spine (Phila Pa 1976),2011,36(20):1658-1664.
19. Harrington PR.Treatment of scoliosis.Correction and internal fixation by spine instrumentation[J].J Bone Joint Surg Am,1962,44-A (4):591-610.
20. Moe JH.A critical analysis of methods of fusion for scoliosis:an evaluation in two hundred and sixty-six patients.1958[J].Clin Orthop Relat Res,2007,460(3):21-28.
21. Tambornino JM,Armbrust EN,Moe JH.Harrington instrumentation in correction of scoliosis.A comparison with cast correction[J].J Bone Joint Surg Am,1964,46(2):313-321.
22. King HA.Selection of fusion levels for posterior instrumentation and fusion in idiopathic scoliosis[J].Orthop Chin North Am,1988,19(2):247-255.
23. Kim YJ,Lenke LG,Cho SK,et al.Comparative analysis of pedicle screw versus hook instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis[J].Spine (Phila Pa 1976),2004,29(18):2040-2048.
24. Suk SI,Lee SM,Chung ER,et al.Selective thoracic fusion with segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis:more than 5-year follow-up[J].Spine (Phila Pa 1976),2005,30(14):1602-1609.
25. Dobbs MB,Lenke LG,Kim YJ,et al.Selective posterior thoracic fusions for adolescent idiopathic scoliosis:comparison of hooks versus pedicle screws[J].Spine (Phila Pa 1976),2006,31(20):2400-2404.
26. Suk SI,Lee SM,Chung ER,et al.Determination of distal fusion level with segmental pedicle screw fixation in single thoracic idiopathic scoliosis[J].Spine (Phila Pa 1976),2003,28(5):484-491.
27. 张宏志,张永刚,张雪松,等.后路选择性融合治疗青少年特发性脊柱侧凸单胸弯[J].中华医学杂志,2007,87(9):599-601.
28. Takahashi J,Newton PO,Ugrinow VL,et al.Selective thoracic fusion in adolescent idiopathic scoliosis:factors influencing the selection of the optimal lowest instrumented vertebra[J].Spine (Phila Pa 1976),2011,36(14):1131-1141.
29. Jansen RC,van Rhijn LW,Duinkerke E,et al.Predictability of the spontaneous lumbar curve correction after selective thoracic fusion in idiopathic scoliosis[J].Eur Spine J,2007,16(9):1335-1342.
30. Thompson JP,Transfeldt EE,Bradford DS,et al.Decompensation after Cotrel-Dubousset instrumentation of idiopathic scoliosis[J].Spine (Phila Pa 1976),1990,15(9):927-931.
31. Lee SM,Suk SI,Chung ER.Direct vertebral rotation:a new technique of three-dimensional deformity correction with segmental pedicle screw fixation in adolescent idiopathic scoliosis[J].Spine (Phila Pa 1976),2004,29(3):343-349.
32. Potter BK,Kuklo TR,Lenke LG.Radiographic outcomes of anterior spinal fusion versus posterior spinal fusion with thoracic pedicle screws for treatment of Lenke TypeⅠ adolescent idiopathic scoliosis curves[J].Spine (Phila Pa 1976),2005,30(16):1859-1866.
33. 刘臻,邱勇.朱泽章.Lenke 1型特发性脊柱侧凸选择性胸弯融合时的下端融合椎选择:T12还是L1?[J].中国矫形外科杂志,2012,20(21):1921-1925.
34. Tao F,Shi Z,Xie Y,et al.Determination of lowest instrumented vertebra by the location of apical vertebra in Lenke type 1 adolescent idiopathic scoliosis[J].Int Orthop,2011,35(4):561-567.
35. Miyanji F,Pawelek JB,Van Valin SE,et al.Is the lumbar modifier useful in surgical decision making? Defining two distinct Lenke 1A curve patterns[J].Spine (Phila Pa 1976),2008,33(23):2545-2551.
36. Cil A,Pekmezci M,Yazici M,et al.The validity of Lenke criteria for defining structural proximal thoracic curves in patients with adolescent idiopathic scoliosis[J].Spine (Phila Pa 1976),2005,30(22):2550-2555.
37. Suk SI,Kim WJ,Kim JH,et al.Indications of proximal thoracic curve fusion in thoracic adolescent idiopathic scoliosis:recognition and treatment of double thoracic curve pattern in adolescent idiopathic scoliosis treated with segmental instrumentation[J].Spine (Phila Pa 1976),2000,25(18):2342-2349.
38. Rose PS,Lenke LG.Classification of operative adolescent idiopathic scoliosis:treatment guidelines[J].Orthop Clin North Am,2007,38(4):521-529.
39. Ilharreborde B,Even J,Lefevre Y,et al.How to determine the upper level of instrumentation in Lenke types 1 and 2 adolescent idiopathic scoliosis:a prospective study of 132 patients[J].J Pediatr Orthop,2008,28(7):733-739.

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