Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing 100730, China.
Chin Med J (Engl). 2010 Jan 20;123(2):151-5.
Treatment of rapidly progressing scoliosis in young children is a challenge for spine surgeons. Some surgeons had begun to use dual growing rod technique for treatment of rapidly progressing scoliosis in young children and had achieved acceptable results. The aim of this study was to determine the primary results and complications of this new technique in China.
Eleven children suffering from rapidly progressing scoliosis were treated with dual growing rod technique between November 2004 and March 2009 at Peking Union Medical College Hospital (PUMCH). There were 10 females and 1 male in the group with Risser sign of 0 grade. The mean age at initial surgery was 6.1 years (range, 2.1-10.9 years). Ten patients were diagnosed as congenital scoliosis and 1 patient neuromuscular scoliosis. All the patients had 1-4 lengthening procedures (mean, 1.8 procedures) after the initial surgeries. The radiographic results of all the patients were investigated.
The coronal Cobb angle of scoliosis improved from (67.64+/-11.43) degrees to (34.64+/-8.26) degrees after initial surgery with the correction rate observed at (47.15+/-16.48)%. The coronal trunk shift improved from (2.00+/-1.73) cm to (1.49+/-1.31) cm after initial surgery. The T1-S1 height increased from (25.47+/-6.16) cm to (28.84+/-5.69) cm after initial surgery. The coronal Cobb angle of scoliosis was (36.82+/-11.76) degrees and the coronal trunk shift was (1.11+/-1.29) cm after the most recent lengthening procedure with the most recent correction rate observed at (44.73+/-19.43)%. The T1-S1 height was (31.29+/-4.50) cm after the most recent lengthening procedure with an average T1-S1 length increase of 1.6 (range, 1.0-2.7) cm per year during the lengthening period. The sagittal balance was maintained. Five of the total patients (45.5%) had complications including: hook displacement, pedical screw loosening, and broken rod. We performed revision surgeries with simultaneous lengthening procedures in all 5 cases with satisfactory results.
The dual growing rod technique was useful in the management of rapidly progressing scoliosis in young children. This technique could control severe scoliosis, allow for spinal growth, and maintain the coronal and sagittal balance. But the technique has high complications requiring strict and regular follow-up.
对于儿童脊柱外科医生来说，治疗进展迅速的脊柱侧弯是一个挑战。一些医生开始使用双生长棒技术治疗儿童进展迅速的脊柱侧弯，并取得了可接受的结果。本研究旨在确定该新技术在中国的主要结果和并发症。
2004 年 11 月至 2009 年 3 月，北京协和医院（PUMCH）共收治 11 例进展迅速的脊柱侧弯患儿，均采用双生长棒技术治疗。其中女性 10 例，男性 1 例，Risser 征 0 级。初次手术时的平均年龄为 6.1 岁（范围 2.1-10.9 岁）。10 例患者诊断为先天性脊柱侧弯，1 例为神经肌肉性脊柱侧弯。所有患者初次手术后均行 1-4 次延长术（平均 1.8 次）。所有患者均进行影像学检查。
初次手术后脊柱侧凸冠状 Cobb 角从（67.64+/-11.43）度改善至（34.64+/-8.26）度，矫正率为（47.15+/-16.48）%。初次手术后，躯干冠状移位从（2.00+/-1.73）cm 改善至（1.49+/-1.31）cm。初次手术后 T1-S1 高度从（25.47+/-6.16）cm 增加至（28.84+/-5.69）cm。末次延长术后，脊柱侧凸冠状 Cobb 角为（36.82+/-11.76）度，冠状躯干移位为（1.11+/-1.29）cm，末次矫正率为（44.73+/-19.43）%。末次延长术后 T1-S1 高度为（31.29+/-4.50）cm，延长期间 T1-S1 长度平均每年增加 1.6（范围 1.0-2.7）cm。矢状位平衡得到维持。11 例患者中，5 例（45.5%）发生并发症，包括钩移位、椎弓根螺钉松动和棒断裂。我们对所有 5 例患者均进行了翻修手术，同时进行了延长手术，结果满意。
双生长棒技术在治疗儿童进展迅速的脊柱侧弯方面是有用的。该技术可以控制严重的脊柱侧弯，允许脊柱生长，并维持冠状位和矢状位平衡。但该技术并发症发生率较高，需要严格、定期随访。
