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远程操作的磁力生长棒在早发性脊柱侧凸中的早期结果。

Early results of a remotely-operated magnetic growth rod in early-onset scoliosis.

机构信息

Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK.

出版信息

Bone Joint J. 2013 Jan;95-B(1):75-80. doi: 10.1302/0301-620X.95B1.29565.

Abstract

Conventional growing rods are the most commonly used distraction-based devices in the treatment of progressive early-onset scoliosis. This technique requires repeated lengthenings with the patient anaesthetised in the operating theatre. We describe the outcomes and complications of using a non-invasive magnetically controlled growing rod (MCGR) in children with early-onset scoliosis. Lengthening is performed on an outpatient basis using an external remote control with the patient awake.Between November 2009 and March 2011, 34 children with a mean age of eight years (5 to 12) underwent treatment. The mean length of follow-up was 15 months (12 to 18). In total, 22 children were treated with dual rod constructs and 12 with a single rod. The mean number of distractions per patient was 4.8 (3 to 6). The mean pre-operative Cobb angle was 69° (46° to 108°); this was corrected to a mean 47° (28° to 91°) post-operatively. The mean Cobb angle at final review was 41° (27° to 86°). The mean pre-operative distance from T1 to S1 was 304 mm (243 to 380) and increased to 335 mm (253 to 400) in the immediate post-operative period. At final review the mean distance from T1 to S1 had increased to 348 mm (260 to 420).Two patients developed a superficial wound infection and a further two patients in the single rod group developed a loss of distraction. In the dual rod group, one patient had pull-out of a hook and one developed prominent metalwork. Two patients had a rod breakage; one patient in the single rod group and one patient in the dual rod group. Our early results show that the MCGR is safe and effective in the treatment of progressive early-onset scoliosis with the avoidance of repeated surgical lengthenings.

摘要

传统的生长棒是治疗早发性进展性脊柱侧凸最常用的撑开式设备。该技术需要在手术室对患者进行麻醉,并反复延长。我们描述了使用非侵入性磁控生长棒(MCGR)治疗早发性脊柱侧凸儿童的结果和并发症。在门诊使用外部遥控器,患者清醒时即可进行延长操作。

2009 年 11 月至 2011 年 3 月,34 名平均年龄为 8 岁(5 至 12 岁)的儿童接受了治疗。平均随访时间为 15 个月(12 至 18 个月)。共有 22 名儿童接受了双棒结构治疗,12 名儿童接受了单棒治疗。每位患者的平均延长次数为 4.8 次(3 至 6 次)。术前 Cobb 角平均为 69°(46°至 108°);术后平均矫正至 47°(28°至 91°)。最终随访时 Cobb 角平均为 41°(27°至 86°)。术前 T1 至 S1 的平均距离为 304mm(243 至 380),术后即刻增加至 335mm(253 至 400)。最终随访时 T1 至 S1 的平均距离增加至 348mm(260 至 420)。

两名患者发生浅表伤口感染,另有两名单棒组患者发生牵引力丧失。在双棒组中,一名患者发生钩脱出,一名患者发生金属突出。两名患者发生棒断裂;一名患者在单棒组,一名患者在双棒组。我们的早期结果表明,MCGR 在治疗早发性进展性脊柱侧凸时是安全有效的,可以避免反复手术延长。

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