Elsebai Hazeem B, Yazici Muharrem, Thompson George H, Emans John B, Skaggs David L, Crawford Alvin H, Karlin Lawrence I, McCarthy Richard E, Poe-Kochert Connie, Kostial Patricia, Akbarnia Behrooz A
Growing Spine Study Group, Hacettepe University Faculty of Medicine, Sihhiye, Ankara.
J Pediatr Orthop. 2011 Jan-Feb;31(1):1-5. doi: 10.1097/BPO.0b013e318202c1f0.
Growing rod surgery is a modern alternative treatment for young children with early onset scoliosis. This is the first study focused on its use in progressive congenital spinal deformities.
A retrospective study of 19 patients from the international multicenter Growing Spine Study Group with progressive congenital spinal deformities undergoing growing rod surgery who had a minimum of 2 years follow-up. We analyzed demographic and radiographic data including age at initial surgery, number of abnormal vertebrae per patient, number of lengthenings postoperatively, Cobb angle of the major curve preoperative, postoperative initial and at last follow-up, T1-S1 length, space available for the lung (SAL), length of follow up, and complications.
The mean age at surgery was 6.9 years (range: 3.2 to 10.7 y). The mean number of affected vertebrae per patient was 5.2 (range: 2 to 9 vertebrae). The mean number of lengthening was 4.2 (range: 1 to 10 lengthening) per patient. The major Cobb angle improved from 66 degrees (range: 40 to 95 degrees) preoperatively to 45 degrees (range: 13 to 79 degrees) initial postoperative and 47 degrees (range: 18 to 78 degrees) at the last follow-up. The mean T1-S1 length increased from 268.3 mm (range: 192 to 322 mm) postoperatively to a mean of 315.4 mm (range: 261 to 357 mm) at last follow-up. The mean T1-S1 length increase was 11.7 mm/y. The SAL ratio increased from 0.81 preoperatively to 0.94 at latest follow-up. The mean postoperative follow-up was 4 years (range: 2 to 6.6 y). Five patients (38%) had undergone final fusion and 14 are still under treatment. Complications have occurred in 8 patients (42%). There were 14 (14%) complications in 100 procedures: 11 implant related, 2 pulmonary, and 1 postoperative infection. There were no neurological complications.
Growing rods are a safe and effective treatment technique in selected patients with congenital spinal deformities. The deformity, spinal growth, and the SAL improved. The incidence of complication was relatively low.
Level IV, case series.
生长棒手术是治疗早发性脊柱侧弯幼儿的一种现代替代疗法。这是第一项聚焦于其在进展性先天性脊柱畸形中应用的研究。
对国际多中心生长性脊柱研究组中19例接受生长棒手术且至少随访2年的进展性先天性脊柱畸形患者进行回顾性研究。我们分析了人口统计学和影像学数据，包括初次手术时的年龄、每位患者异常椎体的数量、术后延长的次数、主要弯术前的Cobb角、术后初期及末次随访时的Cobb角、T1-S1长度、肺可用空间（SAL）、随访时间以及并发症情况。
手术时的平均年龄为6.9岁（范围：3.2至10.7岁）。每位患者受影响椎体的平均数量为5.2个（范围：2至9个椎体）。每位患者延长的平均次数为4.2次（范围：1至10次延长）。主要Cobb角从术前的66度（范围：40至95度）改善至术后初期的45度（范围：13至79度）以及末次随访时的47度（范围：18至78度）。T1-S1平均长度从术后的268.3毫米（范围：192至322毫米）增加至末次随访时的平均315.4毫米（范围：261至357毫米）。T1-S1平均长度增加为每年11.7毫米。SAL比率从术前的0.81增加至最新随访时的0.94。术后平均随访时间为4年（范围：2至6.6年）。5例患者（38%）已接受最终融合，14例仍在接受治疗。8例患者（42%）出现了并发症。100次手术中有14次（14%）出现并发症：11次与植入物相关，2次肺部并发症，1次术后感染。无神经并发症。
对于选定的先天性脊柱畸形患者，生长棒是一种安全有效的治疗技术。畸形、脊柱生长及SAL均得到改善。并发症发生率相对较低。
IV级，病例系列。
