Mechanical Engineering Department, École Polytechnique de Montréal, P.O. Box 6079, Station Centre-ville', Montreal, QC, H3C 3A7, Canada.
Eur Spine J. 2012 Jan;21(1):138-44. doi: 10.1007/s00586-011-1966-4. Epub 2011 Aug 21.
Fusionless growth modulation is an attractive alternative to conventional treatments of idiopathic scoliosis. To date, fusionless devices achieve unilateral growth modulation by compressing the intervertebral disc. This study explores a device to control spinal alignment and vertebral morphology via growth modulation while excluding the disc in a porcine model.
A device that locally encloses the vertebral growth plate exclusive of the disc was introduced anteriorly over T5-T8 in four immature pigs (experimental) while three underwent surgery without instrumentation (sham) and two were selected as controls. Bi-weekly coronal and lateral radiographs were taken over the 12-week follow-up to document vertebral morphology and spinal alignment modifications via an inverse approach (creation of deformity).
All animals completed the experiment with no postoperative complications. Control and sham groups showed no significant changes in spinal alignment. Experimental group achieved a final coronal Cobb angle of 6.5° ± 3.5° (constrained to the four instrumented levels) and no alteration to the sagittal profile was observed. Solely the experimental group ended with consistent vertebral wedging of 4.1° ± 3.6° amounting to a cumulative wedging of up to 25° and a concurring difference in left/right vertebral height of 1.24 ± 1.86 mm in the coronal plane.
The proposed intravertebral epiphyseal device, for the early treatment of progressive idiopathic scoliosis, demonstrated its feasibility by manipulating spinal alignment through the realization of local growth modulation exclusive of the intervertebral disc.
无融合生长调节是治疗特发性脊柱侧凸的一种有吸引力的替代传统方法。迄今为止，无融合器械通过压缩椎间盘来实现单侧生长调节。本研究在猪模型中探索了一种通过生长调节控制脊柱排列和椎体形态而不包括椎间盘的装置。
在 4 头未成熟猪（实验组）的 T5-T8 段前方引入一种仅包围椎间盘的椎体生长板的装置，而另外 3 头进行了无器械手术（假手术组），另有 2 头作为对照。在 12 周的随访中，每两周拍摄一次冠状位和侧位 X 线片，通过逆方法（畸形的产生）记录椎体形态和脊柱排列的改变。
所有动物均完成实验，无术后并发症。对照组和假手术组的脊柱排列无明显变化。实验组最终获得 6.5°±3.5°的冠状 Cobb 角（限于 4 个器械固定水平），矢状位无明显改变。仅实验组出现一致的椎体楔形改变，平均为 4.1°±3.6°，累计楔形改变达 25°，冠状面左右椎体高度差异为 1.24±1.86mm。
所提出的椎体内骺板装置，用于早期治疗进展性特发性脊柱侧凸，通过实现椎间盘以外的局部生长调节来操纵脊柱排列，证明了其可行性。
