Luhmann Scott J, Smith June C, McClung Ann, McCullough Frances L, McCarthy Richard E, Thompson George H
St Louis Shriners Hospital, 4400 Clayton Ave, St Louis, MO 63110, USA; St Louis Childrens Hospital, One Childrens Place, St Louis, MO 63110, USA.
Wash U Ortho Surgery, 660 S. Euclid Ave, Campus Box 8233, St Louis, MO 63110, USA.
Spine Deform. 2017 Jul;5(4):277-282. doi: 10.1016/j.jspd.2017.01.011.
Retrospective review of a multicenter database.
To compare the radiographic outcomes of patients who had undergone the Shilla Growth Guidance System (SGGS) and traditional growing rod (GR) treatment for management of early-onset scoliosis (EOS) through definitive treatment.
The efficacy of surgical treatment of EOS can only be determined after definitive treatment has been completed. We wanted to review our experience with the SGGS and GR for management of EOS through definitive treatment.
Patients who had surgical treatment with SGGS or GR and had undergone definitive treatment were included. The patients were matched by age, preoperative curve magnitude, and diagnosis. The study population consisted of 36 patients (18 in each group) whose mean age at initial surgery was as follows: SGGS, 7.9 years; and GR, 7.7 years (not significant [NS]). Length of follow-up after initial surgery was 6.1 years for SGGS and 7.4 years for GR (NS). Definitive treatment was posterior spinal fusion (15 SGGS, 17 GR), implant removal (3 SGGS), or completion of lengthenings (1 GR).
The preoperative curve was 61 degrees for SGGS and 65 degrees for GR (NS). After index surgery, the major curve decreased to 24 degrees (-37 degrees) for SGGS and 38 (-27 degrees) for GR (p < .05). At last follow-up, the major curve was 34 degrees (44%) for SGGS and 36 degrees (45%) for GR (NS). The initial T1-T12 length for SGGS was 188 mm and for GR, 181 mm; at last follow-up, SGGS was 234 mm (46 mm increase) and GR was 233 mm (52 mm increase) (NS).
Our analysis shows the final radiographic outcomes (and changes) and complications (implant-related and infection) between the SGGS and GR groups were not statistically different. The main difference between the two groups was the threefold difference in overall surgeries.
对多中心数据库进行回顾性分析。
比较接受新罗生长引导系统（SGGS）和传统生长棒（GR）治疗的早发性脊柱侧凸（EOS）患者经最终治疗后的影像学结果。
EOS手术治疗的疗效只能在完成最终治疗后才能确定。我们希望通过最终治疗回顾我们使用SGGS和GR治疗EOS的经验。
纳入接受SGGS或GR手术治疗并已接受最终治疗的患者。患者按年龄、术前侧弯度数和诊断进行匹配。研究人群包括36例患者（每组18例），初次手术时的平均年龄如下：SGGS组为7.9岁；GR组为7.7岁（无显著差异[NS]）。初次手术后SGGS组的随访时间为6.1年，GR组为7.4年（无显著差异）。最终治疗为后路脊柱融合术（SGGS组15例，GR组17例）、取出内固定物（SGGS组3例）或完成延长术（GR组1例）。
SGGS组术前侧弯度数为61度，GR组为65度（无显著差异）。初次手术后，SGGS组主弯降至24度（减少37度），GR组降至38度（减少27度）（p < 0.05）。末次随访时，SGGS组主弯为34度（改善44%），GR组为36度（改善45%）（无显著差异）。SGGS组最初的T1 - T12长度为188 mm，GR组为181 mm；末次随访时，SGGS组为234 mm（增加46 mm），GR组为233 mm（增加52 mm）（无显著差异）。
我们的分析表明，SGGS组和GR组之间最终的影像学结果（及变化）和并发症（与内固定相关及感染）无统计学差异。两组之间的主要差异在于总体手术次数相差三倍。
