Shriners Hospital for Children-Philadelphia, Philadelphia, PA, USA.
Spine (Phila Pa 1976). 2010 Oct 15;35(22):E1199-203. doi: 10.1097/BRS.0b013e3181e21b50.
Retrospective case review of skeletally immature patients treated with growing rods. Patients received an average of 9.6 years follow-up care.
(1) to identify the rate of autofusion in the growing spine with the use of growing rods; (2) to quantify how much correction can be attained with definitive instrumented fusion after long-term treatment with growing rods; and (3) to describe the extent of Smith-Petersen osteotomies required to gain correction of an autofused spine following growing rod treatment.
The safety and use of growing rods for curve correction and maintenance in the growing spine population has been established in published reports. While autofusion has been reported, the prevalence and sequelae are not known.
Nine skeletally immature children with scoliosis were identified who had been treated using growing rods. A retrospective review of the medical records and radiographs was conducted and the following data collected: complications, pre- and postoperative Cobb angles at time of initial surgery (growing rod placement), pre- and postoperative Cobb angles at time of final surgery (growing rod removal and definitive fusion), total spine length as measured from T1-S1, % correction since initiation of treatment and at definitive fusion, total number of surgeries, and number of patients found to have autofusion at the time of device removal.
The rate of autofusion in children treated with growing rods was 89%. The average percent of the Cobb angle correction obtained at definitive fusion was 44%. On average, 7 osteotomies per patient were required at the time of definitive fusion due to autofusion.
Although growing rods have efficacy in the control of deformity within the growing spine, they also have adverse effects on the spine. Immature spines treated with a growing rod have high rates of unintended autofusion which can possibly lead to difficult and only moderate correction at the time of definitive fusion.
对使用生长棒治疗的未成熟骨骼患者进行回顾性病例回顾。患者接受了平均 9.6 年的随访护理。
(1) 确定使用生长棒的生长脊柱中的自发融合率；(2) 量化长期使用生长棒治疗后通过最终仪器融合可以获得多少矫正；(3) 描述在生长棒治疗后获得自发融合脊柱矫正所需的 Smith-Petersen 截骨术的程度。
生长棒在生长脊柱人群中的曲线矫正和维持的安全性和使用已在已发表的报告中得到证实。虽然已经报道了自发融合，但流行率和后果尚不清楚。
确定了 9 名患有脊柱侧凸的未成熟儿童，他们曾使用生长棒进行治疗。对病历和 X 光片进行了回顾性审查，并收集了以下数据：并发症、初次手术（生长棒放置）时的术前和术后 Cobb 角、最终手术（生长棒取出和最终融合）时的术前和术后 Cobb 角、从 T1-S1 测量的整个脊柱长度、从开始治疗到最终融合的矫正百分比、总手术次数，以及在设备移除时发现有自发融合的患者人数。
接受生长棒治疗的儿童中，自发融合率为 89%。在最终融合时获得的 Cobb 角矫正平均百分比为 44%。平均而言，由于自发融合，每个患者在最终融合时需要 7 次截骨术。
尽管生长棒在控制生长脊柱中的畸形方面具有疗效，但它们也对脊柱有不良影响。使用生长棒治疗的不成熟脊柱有很高的自发融合率，这可能导致在最终融合时难以获得且仅适度的矫正。
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