Sun Zhi-jian, Qiu Gui-xing, Zhao Yu, Guo Shi-gong, Zhang Jian-guo, Shen Jian-xiong, Wang Yi-Peng, Zhao Hong, Li Shu-gang
Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng District Shuaifuyuan No.1, Beijing, 100730, China.
Eur Spine J. 2015 Jul;24(7):1434-40. doi: 10.1007/s00586-014-3668-1. Epub 2014 Nov 11.
To investigate changes in thoracic dimensions (TDs) following repeated lengthening surgeries after dual growing rod treatment of early onset scoliosis and thereby its effect on thoracic growth.
All EOS patients treated with dual growing rod technique in Peking Union Medical College Hospital from June 2004 to June 2014 were retrospectively reviewed. Thoracic spine height (T1-T12), total spine height (T1-S1), maximal coronal chest width and pelvic inlet width (PIW) were measured on the posteroanterior X-ray images after initial growing rod insertion surgery and after each lengthening surgery. Absolute TDs measurements were normalized by PIW. Changes of absolute and normalized TDs measurements with age and number of lengthening surgeries were analyzed.
Radiographs of 229 surgeries of 53 EOS patients were measured, including 49 images after initial growing rod insertion surgery and 180 images of lengthening surgeries. Significant positive correlations between age and all three absolute TDs were found (P < 0.01) whereas significant negative correlations between age and all three normalized TDs (P < 0.01) were identified. Similarly, negative correlations were also identified between number of lengthening surgeries and the three normalized TDs (P < 0.01). Significant differences of normalized TDs were identified between initial surgery and the first lengthening through covariance analysis (P < 0.01). Yet, such differences were seldom seen between every two adjacent lengthening surgeries.
Growing rod technique could maintain TDs growth through repeated lengthening procedures but the growth rate was compromised as the number of lengthening procedures increased.
研究早发性脊柱侧凸双生长棒治疗后重复延长手术对胸廓尺寸（TDs）的影响，及其对胸廓生长的作用。
回顾性分析2004年6月至2014年6月在北京协和医院接受双生长棒技术治疗的所有早发性脊柱侧凸（EOS）患者。在初次植入生长棒手术后及每次延长手术后，于正位X线片上测量胸椎高度（T1-T12）、全脊柱高度（T1-S1）、最大冠状胸廓宽度和骨盆入口宽度（PIW）。绝对TDs测量值用PIW进行标准化。分析绝对和标准化TDs测量值随年龄及延长手术次数的变化。
测量了53例EOS患者229次手术的X线片，包括初次植入生长棒手术后的49张影像和延长手术的180张影像。发现年龄与所有三个绝对TDs之间存在显著正相关（P < 0.01），而年龄与所有三个标准化TDs之间存在显著负相关（P < 0.01）。同样，延长手术次数与三个标准化TDs之间也存在负相关（P < 0.01）。通过协方差分析，初次手术与首次延长之间标准化TDs存在显著差异（P < 0.01）。然而，每两次相邻延长手术之间很少见到这种差异。
生长棒技术可通过重复延长手术维持TDs生长，但随着延长手术次数增加，生长速率会受到影响。
