Department of Orthopedics, Changzheng Hospital, Second Affiliated Hospital of Second Military Medical University, Shanghai, P.R. China.
Department of Orthopedics, Changzheng Hospital, Second Affiliated Hospital of Second Military Medical University, Shanghai, P.R. China.
World Neurosurg. 2019 Jun;126:e173-e180. doi: 10.1016/j.wneu.2019.01.290. Epub 2019 Feb 22.
To determine the safety and effectiveness of the combined halo gravity traction and dual growing rod technique in achieving and maintaining scoliosis correction while allowing spinal growth.
From January 2014 to July 2017, 11 patients with dystrophic neurofibromatosis type 1 (NF1)-associated scoliosis, including 7 men and 4 women, underwent combined halo gravity traction and dual growing rod technique procedures. Diagnoses were all dystrophic NF1-associated scoliosis. Patients with a Cobb angle of major curve >60° and flexibility of spine <30% were included in our research. Analysis included age at the time of treatment, levels of instrumentation, number and frequency of lengthening, lengthening distance, and complications. The changes in Cobb angle of scoliosis and T1-S1 length of spine over the treatment period were measured by radiographic evaluation.
The average age of treated patients was 7.2 years (range, 5-9 years). Growing rods were lengthened every 6 months through exposure. The mean number of times of lengthening was 3.9 (range, 3-5). The distance of each extension was 1.6 cm (range, 1.0-2.0 cm). The Cobb angle was corrected 41.7% on average after traction, 48.4% after initial surgery, and 53.3% at the last follow-up. T1-S1 length increased 3.4 cm (range, 1.2-5.1 cm) on average over a mean treatment period of 2.2 years, with an average of 1.5 cm/y (range, 0.5-2.3 cm/y). During the treatment period, complication of hook dislodgement occurred in 1 of 11 patients (9.1%).
The combined halo gravity traction and dual growing rod technique can safely and effectively correct NF1-associated scoliosis. This is an ongoing study that requires long-term follow-up.
确定联合使用 halo 重力牵引和双生长棒技术在实现和维持脊柱侧凸矫正的同时允许脊柱生长的安全性和有效性。
从 2014 年 1 月至 2017 年 7 月，11 例神经纤维瘤病 1 型（NF1）相关脊柱侧凸患者（包括 7 名男性和 4 名女性）接受了联合 halo 重力牵引和双生长棒技术治疗。所有患者的诊断均为营养不良型 NF1 相关脊柱侧凸。我们的研究纳入了主弯 Cobb 角＞60°且脊柱柔韧性＜30%的患者。分析包括治疗时的年龄、器械的节段数、延长的次数和频率、延长的距离以及并发症。通过放射学评估测量治疗期间脊柱侧凸 Cobb 角和 T1-S1 长度的变化。
治疗患者的平均年龄为 7.2 岁（范围 5-9 岁）。通过暴露进行生长棒每 6 个月延长一次。平均延长次数为 3.9 次（范围 3-5 次）。每次延长的距离为 1.6 cm（范围 1.0-2.0 cm）。牵引后 Cobb 角平均矫正 41.7%，初次手术后矫正 48.4%，末次随访时矫正 53.3%。在平均 2.2 年的治疗期间，T1-S1 长度平均增加 3.4 cm（范围 1.2-5.1 cm），平均每年增加 1.5 cm（范围 0.5-2.3 cm）。在治疗期间，11 例患者中有 1 例（9.1%）发生钩脱落并发症。
联合使用 halo 重力牵引和双生长棒技术可以安全有效地矫正 NF1 相关脊柱侧凸。这是一项正在进行的研究，需要长期随访。
