Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran.
Orthopedic Spine Surgery Department, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2018 Dec 1;21(12):595-599.
Growing rods are increasingly used for treatment of early onset scoliosis (EOS) worldwide. Beside promising outcomes, some authors are concerned about high rates of complications. In the current clinical trial, complications of EOS surgery using dual growing rods were investigated.
Between June 2006 and February 2017, twenty-two consecutive patients with a coronal curve >45 degrees underwent serial surgical correction using dual growing rods at Shafa Orthopedic hospital, Tehran, I.R. Iran. The rods were secured using hooks or screws or both. The patients were followed for 5.2 ± 1.7 years on average. Wilcoxon test was utilized to compare the pre- and post-operative values. P < 0.05 was considered significant.
The scoliotic and kyphotic curves decreased significantly from 52 ± 24° to 38 ± 19° and from 78 ± 22° to 60 ± 17°, respectively (P < 0.001). Total rate of implant-related complications (IRCs) and surgical site complications (SSCs) were 54.5% (12 patients) and 22.7% (5 patients), respectively. Malpositioned pedicular screw was found in 2 patients.
EOS can be effectively corrected using dual growing rods, however, considerable rates of IRC are of concern (54.5%). It seems necessary to compare the efficacy and complication rate of newer devices with those of growing rods in future studies.
全球范围内,生长棒越来越多地用于治疗早发性脊柱侧凸(EOS)。除了有良好的治疗效果外,一些作者对高并发症发生率表示担忧。在当前的临床试验中,研究了使用双生长棒治疗 EOS 手术的并发症。
2006 年 6 月至 2017 年 2 月期间,在伊朗德黑兰 Shafa 骨科医院,连续 22 例冠状面曲线>45 度的患者使用双生长棒进行了系列手术矫正。棒通过钩或螺钉或两者固定。患者平均随访 5.2±1.7 年。采用 Wilcoxon 检验比较术前和术后的值。P<0.05 被认为有统计学意义。
脊柱侧凸和后凸曲线分别从 52±24°显著减少至 38±19°和从 78±22°减少至 60±17°(P<0.001)。与植入物相关的并发症(IRCs)和手术部位并发症(SSCs)的总发生率分别为 54.5%(12 例)和 22.7%(5 例)。2 例患者发现椎弓根螺钉位置不当。
使用双生长棒可有效矫正 EOS,但 IRC 的发生率相当高(54.5%)。在未来的研究中,有必要比较新型器械的疗效和并发症发生率与生长棒的疗效和并发症发生率。