磁控生长棒治疗早发性脊柱侧弯：2例患者的早期结果

Magnetic Controlled Growing Rods as a Treatment of Early Onset Scoliosis: Early Results With Two Patients.

作者信息

Heydar Ahmed Majid, Şirazi Serdar, Bezer Murat

机构信息

Medistate Hospital, Rüzgarlibahçe Mah., Istanbul, Turkey.

Heybeliada Mah., Istanbul, Turkey.

出版信息

Spine (Phila Pa 1976). 2016 Nov 15;41(22):E1336-E1342. doi: 10.1097/BRS.0000000000001614.

DOI:10.1097/BRS.0000000000001614

PMID:27831988

Abstract

STUDY DESIGN

Prospective unicentral nonrandomized study.

OBJECTIVE

To evaluate the safety and effectivity profile of magnetic controlled growing rods (MCGR) in patients with early onset scoliosis (EOS).

SUMMARY OF BACKGROUND DATA

Conventional growing rods are the most commonly used growth sparring devices in the treatment of EOS, as this technique requires repeated surgical operations for lengthening; it is associated with high rate of complications and increased costs. MCGR in treatment of EOS is effective in correcting deformity whereas allowing continuous spinal growth as reported by a few studies.

METHODS

A total of 18 patients with progressive EOS were treated by MCGR, two of them had undergone final fusion operation. Patients were followed-up for a minimium time of 9 months from the time of initial surgery. Radiological data were analyzed in terms of Cobb angle, kyphosis angle, T1-T12, and T1-S1 distances in preoperative, postoperative, and last follow up.

RESULTS

The mean preoperative Cobb and kyphosis angle were 68° (44-116°) and 43° (98-24°), it was corrected to 35° (67-12°) and 29° (47-21°) immediately after initial operation and maintained at 34.5° (52-10°) and 33° (52-20°) at last follow up, respectively.The mean preoperative T1-T12 and T1-S1 distance were 171 mm (202-130 mm) and 289 mm (229-370 mm), it was increased to 197 mm (158-245 mm) and 330 mm (258-406mm) immediately after initial operation and further increased to 215 mm (170-260 mm) and 357 mm (277-430 mm) at last follow up, respectively.Two patients had undergone final fusion, they had overall mean Cobb angle correction of 66° (62-70°), and kyphosis angle change of 53° (26-80°). Total height gain in T1-T12 and T1-S1 of 80.5 mm (67-94 mm) and 119 mm (105-133 ), respectively.

CONCLUSION

MCGR is safe and effective technique in correction of EOS deformity and in maintaining the correction during nonsurgical distraction procedures. A further correction of the deformity and more spinal height gain can be achieved in the final fusion operation.

LEVEL OF EVIDENCE

摘要

研究设计

前瞻性单中心非随机研究。

目的

评估磁控生长棒（MCGR）治疗早发性脊柱侧弯（EOS）患者的安全性和有效性。

背景数据总结

传统生长棒是治疗EOS最常用的生长保留装置，由于该技术需要反复手术延长；它与高并发症发生率和成本增加相关。少数研究报道，MCGR治疗EOS在矫正畸形方面有效，同时允许脊柱持续生长。

方法

共18例进展性EOS患者接受MCGR治疗，其中2例已接受最终融合手术。患者从初次手术时起至少随访9个月。分析术前、术后及末次随访时的Cobb角、后凸角、T1-T12和T1-S1距离的放射学数据。

结果

术前Cobb角和后凸角的平均值分别为68°（44-116°）和43°（9-24°），初次手术后立即矫正至35°（6-12°）和29°（4-21°），末次随访时分别维持在34.5°（5-10°）和33°（5-20°）。术前T1-T12和T1-S1距离的平均值分别为171mm（130-202mm）和289mm（229-370mm），初次手术后立即增加至197mm（158-245mm）和330mm（258-406mm），末次随访时进一步增加至215mm（170-260mm）和357mm（277-430mm）。2例患者接受了最终融合，他们的Cobb角总体平均矫正为66°（62-70°），后凸角变化为53°（2-80°）。T1-T12和T1-S1的总身高增加分别为80.5mm（67-94mm）和119mm（105-133mm）。