儿童和青少年特发性脊柱侧凸:手术治疗的新兴技术。
Idiopathic Scoliosis in Children and Adolescents: Emerging Techniques in Surgical Treatment.
机构信息
Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
出版信息
World Neurosurg. 2019 Oct;130:e737-e742. doi: 10.1016/j.wneu.2019.06.207. Epub 2019 Jul 5.
BACKGROUND
Idiopathic scoliosis is the most common spinal disorder in the pediatric population. The goals of treatment for pediatric idiopathic scoliosis are to correct deformity, prevent curve progression, restore trunk symmetry and balance, and minimize pain and morbidity. Surgical treatment has advanced significantly, from the advent of segmental pedicle screw instrumentation several decades ago to the recent development of robotic-assisted surgery and growth-modulating fusionless surgery. The objective of the present study was to review the reported data on emerging techniques in the surgical treatment of idiopathic scoliosis in children and adolescents.
METHODS
The PubMed and Google Scholar electronic databases were used to identify studies that had examined new emerging techniques in the surgical treatment of idiopathic scoliosis in children and adolescents.
RESULTS
Major developments in the surgical techniques for pediatric idiopathic scoliosis have included robotic-assisted pedicle screw placement, vertebral body stapling, vertebral body tethering, magnetically controlled growing rods, ApiFix (not currently approved for use in the United States by the Food and Drug Administration), and sublaminar polyester bands. Such growth-modulating fusionless surgical techniques have received increasing attention in recent years, especially for the younger pediatric scoliosis population with significant growth potential remaining.
CONCLUSIONS
Various emerging techniques in the surgical treatment of idiopathic scoliosis in children and adolescents have demonstrated promising results in the reported data thus far. However, longer term prospective studies with larger cohorts are necessary to better evaluate their safety and efficacy.
背景
特发性脊柱侧凸是儿童中最常见的脊柱疾病。特发性儿童脊柱侧凸的治疗目标是纠正畸形、防止曲线进展、恢复躯干对称性和平衡,以及最大限度地减少疼痛和发病率。手术治疗有了显著的进步,从几十年前出现的节段性椎弓根螺钉器械到最近的机器人辅助手术和生长调节非融合手术的发展。本研究的目的是回顾儿童和青少年特发性脊柱侧凸手术治疗中新兴技术的报告数据。
方法
使用 PubMed 和 Google Scholar 电子数据库,确定了研究儿童和青少年特发性脊柱侧凸手术治疗中新兴技术的研究。
结果
小儿特发性脊柱侧凸手术技术的主要进展包括机器人辅助椎弓根螺钉放置、椎体钉钉、椎体系绳、磁控生长棒、ApiFix(目前尚未获得美国食品和药物管理局的批准)和皮下聚酯带。近年来,这种生长调节非融合手术技术受到了越来越多的关注,特别是对于仍有大量生长潜力的年轻儿童脊柱侧凸患者。
结论
迄今为止,在报告的数据中,儿童和青少年特发性脊柱侧凸手术治疗的各种新兴技术显示出了有希望的结果。然而,需要进行更长时间的前瞻性研究,以获得更大的队列,从而更好地评估其安全性和有效性。