Lebon Julie, Batailler Cécile, Wargny Matthieu, Choufani Elie, Violas Philippe, Fron Damien, Kieffer Jerry, Accadbled Franck, Cunin Vincent, De Gauzy Jérôme Sales
Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
, 26 rue Dupont, 31500, Toulouse, France.
Eur Spine J. 2017 Jun;26(6):1567-1576. doi: 10.1007/s00586-016-4929-y. Epub 2016 Dec 31.
Preliminary results of magnetically controlled growing rods (MCGR) are encouraging. However, only short case series of MCGR for the treatment of early onset scoliosis (EOS) have been reported. Our aim was to evaluate its effectiveness and complications.
We report a 30-case retrospective, consecutive, multicenter series of MCGR. Effectiveness was judged upon: deformity correction and difficulties to achieve desired distraction. Secondary endpoints included complications and revision surgeries.
Median age at surgery was 9.1 years (5-13). Mean follow-up was 18.4 months (12-33.9). Mean Cobb angle was 66° preoperatively and 44° at latest follow-up. MCGR has avoided an average of 2.03 scheduled surgical procedures per patient compared to traditional growing rod (GR). The intended total length gain was 40.1 mm per patient (5-140) and the total measured length gain was 21.9 mm (45.5% discrepancy). There were 24 complications: 7 proximal pull-outs of the hooks, 3 rod breakages, 6 failures of the lengthening of which 4 complete blockages and 2 complete blockages followed by backtracking, 1 proximal junctional kyphosis, 1 wound dehiscence, 1 superficial infection, 1 deep infection requiring implant removal, 1 pulmonary embolism, 1 pulmonary insufficiency, 1 secondary lumbar scoliosis, and 1 painful outpatient distraction. Eight patients had a gradual loss of effectiveness of distractions. There were 13 revision surgeries in 9 patients.
MCGR provides satisfactory deformity correction and avoids repeated surgical procedures for lengthening. However, it has substantial complication rate. Although less frequent than in GR, the law of diminishing returns also applies to MCGR.
磁控生长棒（MCGR）的初步结果令人鼓舞。然而，仅有关于MCGR治疗早发性脊柱侧弯（EOS）的简短病例系列报道。我们的目的是评估其有效性及并发症。
我们报告了一组30例的MCGR回顾性、连续性、多中心病例系列。有效性通过以下方面判断：畸形矫正以及实现预期撑开的难度。次要终点包括并发症和翻修手术。
手术时的中位年龄为9.1岁（5 - 13岁）。平均随访时间为18.4个月（12 - 33.9个月）。术前平均Cobb角为66°，最近一次随访时为44°。与传统生长棒（GR）相比，MCGR平均为每位患者避免了2.03次预定的手术操作。预期的每位患者总长度增加为40.1毫米（5 - 140毫米），实际测量的总长度增加为21.9毫米（差异为45.5%）。共出现24例并发症：7例钩子近端拔出、3例棒体断裂、6例延长失败，其中4例完全阻塞，2例完全阻塞后出现回退、1例近端交界性后凸、1例伤口裂开、1例浅表感染、1例深部感染需取出植入物、1例肺栓塞、1例肺功能不全、1例继发性腰椎侧弯、1例门诊撑开时疼痛。8例患者出现撑开效果逐渐丧失。9例患者进行了13次翻修手术。
MCGR提供了令人满意的畸形矫正，并避免了重复进行延长手术。然而，其并发症发生率较高。尽管比GR少见，但收益递减规律同样适用于MCGR。
