Wall Eric J, Bylski-Austrow Donita I, Kolata Ronald J, Crawford Alvin H
Children's Hospital Medical Center and The University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Spine (Phila Pa 1976). 2005 May 15;30(10):1148-53. doi: 10.1097/01.brs.0000162278.68000.91.
An in vivo porcine model of progressive scoliosis as an inverse analog of a proposed method of early surgical treatment.
To test the hypothesis that scoliotic curvatures may be repeatedly created using anatomically based vertebral staples and thoracoscopic surgical procedures.
Staple hemiepiphysiodesis is an established method for treating knee deformities. Similar procedures have so far failed to arrest or correct deformities of the spine. While experimental studies continue to suggest that spine growth is modifiable, no prior clinically translatable method has been shown to clearly and consistently alter vertebral growth.
Custom spine staples were implanted into midthoracic vertebrae of seven skeletally immature normal pigs. Each staple spanned an intervertebral disc and two growth plates and was fixed to adjacent vertebrae with screws. The animals were anesthetized biweekly for radiography during the 8-week study period. Final radiographs were taken after spine harvest. Initial and final postoperative Cobb angles were compared statistically.
Five animals completed the protocol with a weight increase of 142% in 8 weeks. Coronal plane curvatures increased significantly with time, from 0.8 (+/-1.8) to 22.4 (+/-2.8; P = 0.0001). On average, sagittal plane curvatures did not increase with time.
Spinal hemiepiphysiodesis using an anatomically based implant and minimally invasive procedures repeatedly induced spine curvature in a normal porcine model. These techniques may slow, and perhaps even correct, early progressive spine deformity without long rod instrumentation or fusion.
一种渐进性脊柱侧弯的体内猪模型，作为一种拟议的早期手术治疗方法的反向模拟。
检验以下假设，即使用基于解剖学的椎体钉和胸腔镜手术程序可反复造成脊柱侧弯畸形。
钉半骨骺阻滞术是治疗膝关节畸形的既定方法。迄今为止，类似的手术未能阻止或纠正脊柱畸形。虽然实验研究不断表明脊柱生长是可改变的，但此前尚无已证明能明确且持续改变椎体生长的临床可转化方法。
将定制的脊柱钉植入7只骨骼未成熟的正常猪的胸椎中部。每个钉子跨越一个椎间盘和两个生长板，并用螺钉固定到相邻椎体。在为期8周的研究期间，每两周对动物进行一次麻醉以进行放射照相。脊柱取出后拍摄最终的X光片。对术后初始和最终的Cobb角进行统计学比较。
5只动物完成了实验方案，8周内体重增加了142%。冠状面弯曲度随时间显著增加，从0.8（±1.8）增至22.4（±2.8；P = 0.0001）。平均而言，矢状面弯曲度未随时间增加。
在正常猪模型中，使用基于解剖学的植入物和微创手术进行脊柱半骨骺阻滞术可反复诱发脊柱弯曲。这些技术可能减缓甚至纠正早期进行性脊柱畸形，而无需使用长杆器械或融合术。
