Nnadi C, Thakar C, Wilson-MacDonald J, Milner P, Rao A, Mayers D, Fairbank J, Subramanian T
Spinal Unit, Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX3 7HE, UK.
The Leeds Teaching Hospital NHS Trust, Leeds LS13 EX, UK.
Bone Joint J. 2018 Apr 1;100-B(4):507-515. doi: 10.1302/0301-620X.100B4.BJJ-2017-0813.R1.
The primary aim of this study was to evaluate the performance and safety of magnetically controlled growth rods in the treatment of early onset scoliosis. Secondary aims were to evaluate the clinical outcome, the rate of further surgery, the rate of complications, and the durability of correction.
We undertook an observational prospective cohort study of children with early onset scoliosis, who were recruited over a one-year period and followed up for a minimum of two years. Magnetically controlled rods were introduced in a standardized manner with distractions performed three-monthly thereafter. Adverse events which were both related and unrelated to the device were recorded. Ten children, for whom relevant key data points (such as demographic information, growth parameters, Cobb angles, and functional outcomes) were available, were recruited and followed up over the period of the study. There were five boys and five girls. Their mean age was 6.2 years (2.5 to 10).
The mean coronal Cobb angle improved from 57.6° (40° to 81°) preoperatively, 32.8° (28° to 46°) postoperatively, and 41° (19° to 57°) at two years. Five children had an adverse event, with four requiring return to theatre, but none were related to the device. There were no neurological complications or infections. No devices failed. One child developed a proximal junctional kyphosis. The mean gain in spinal column height from T1 to S1 was 45.4 mm (24 to 81) over the period of the study.
Magnetically controlled growth rods provide an alternative solution to traditional growing rods in the surgical management of children with early onset scoliosis, supporting growth of the spine while controlling curve progression. Their use has clear psychosocial and economic benefits, with the reduction of the need for repeat surgery as required with traditional growing rods. Cite this article: Bone Joint J 2018;100-B:507-15.
本研究的主要目的是评估磁控生长棒治疗早发性脊柱侧弯的性能和安全性。次要目的是评估临床疗效、再次手术率、并发症发生率以及矫正的持久性。
我们对早发性脊柱侧弯儿童进行了一项观察性前瞻性队列研究,这些儿童在一年时间内被招募,并至少随访两年。以标准化方式植入磁控生长棒,此后每三个月进行一次撑开操作。记录与器械相关和不相关的不良事件。招募了10名儿童,在研究期间对其进行随访,这些儿童可获取相关关键数据点(如人口统计学信息、生长参数、Cobb角和功能结局)。其中有5名男孩和5名女孩。他们的平均年龄为6.2岁(2.5至10岁)。
平均冠状面Cobb角术前为57.6°(40°至81°),术后为32.8°(28°至46°),两年时为41°(19°至57°)。5名儿童发生了不良事件,其中4名需要返回手术室,但均与器械无关。没有神经并发症或感染。没有器械出现故障。1名儿童出现了近端交界性后凸畸形。在研究期间,从T1至S1的脊柱高度平均增加了45.4毫米(24至81毫米)。
在早发性脊柱侧弯儿童的手术治疗中,磁控生长棒为传统生长棒提供了一种替代解决方案,在控制侧弯进展的同时支持脊柱生长。其应用具有明显的心理社会和经济效益,减少了传统生长棒所需的重复手术需求。引用本文:《骨与关节杂志》2018年;100-B:507-15。