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可伸缩生长棒在早发性脊柱侧弯治疗中的新应用:猪模型的实验研究。

Novel use of telescoping growth rods in treatment of early onset scoliosis: An and study in a porcine model.

作者信息

Vaudreuil Nicholas, Xue Jingbo, Ramanathan Rahul, Tisherman Robert, Dombrowski Malcolm, Wang Wen-Jun, Bell Kevin

机构信息

Department of Orthopaedic Surgery, School of Medicine University of Pittsburgh Pittsburgh Pennsylvania.

Department of Spine Surgery the First Affiliated Hospital of University of South China Hengyang City Hunan Province China.

出版信息

JOR Spine. 2018 Oct 8;1(4):e1035. doi: 10.1002/jsp2.1035. eCollection 2018 Dec.

Abstract

INTRODUCTION

Treatment of early-onset scoliosis (EOS) can be difficult. Various forms of growing rods exist to correct deformity while delaying definitive spinal fusion. The disadvantage of traditional growing rods is need for repeated surgical lengthening procedures. Telescoping growth rods (TelGR) are a prototype new, guided growth technology with a rod mechanism that allows spontaneous longitudinal growth over time without manual lengthening. We hypothesized that the TelGR system will permit unrestricted growth with limited complications through 12 weeks , and that the range of motion (RoM) in each of three directions and stiffness of the TelGR system would not be significantly different than the rigid rod system .

MATERIALS AND METHODS

: Six immature pigs were surgically implanted with TelGR with cephalad fixation at T6-7 and caudal fixation at T14-L1. Radiographs of the involved vertebral segments were measured postoperatively and after 12 weeks. : A robotic testing system was utilized for flexibility tests in flexion-extension (FE), lateral bending (LB), and axial rotation (AR) of eight immature porcine specimens (T3-T15). Testing was performed on both dual rigid rods and bilateral TelGR with instrumentation at T4-5 and T13-14.

RESULTS

: Over the 12-week period, the rod length of the TelGR increased an average of 65 mm. : TelGR demonstrated significantly increased motion in LB and AR RoM compared with rigid rods. No difference was noted in FE RoM.

DISCUSSION

The results in this study showed expected skeletal growth with spines instrumented with TelGR. findings of increased RoM in AR and LB suggest that the TelGR system may be less rigid than traditional growing rods. Treatment with TelGR might, if proven efficacious in the clinical setting, decrease the need for repeated surgical intervention compared with traditional growing rods. This study adds to the limited body of biomechanical evidence examining guided growth technology.

摘要

引言

早发性脊柱侧弯(EOS)的治疗可能具有挑战性。存在多种形式的生长棒用于矫正畸形,同时推迟最终的脊柱融合。传统生长棒的缺点是需要重复进行手术延长操作。可伸缩生长棒(TelGR)是一种新型的引导生长技术原型,其棒机制允许随着时间自发纵向生长,无需手动延长。我们假设TelGR系统在12周内将允许不受限制的生长且并发症有限,并且TelGR系统在三个方向上的每个方向的运动范围(RoM)和刚度与刚性棒系统相比不会有显著差异。

材料与方法

六只未成年猪接受手术,在T6 - 7处进行头端固定,在T14 - L1处进行尾端固定,植入TelGR。术后及12周后对受累椎体节段进行X线片测量。:使用机器人测试系统对八个未成年猪标本(T3 - T15)进行屈伸(FE)、侧弯(LB)和轴向旋转(AR)的柔韧性测试。在T4 - 5和T13 - 14处使用器械对双刚性棒和双侧TelGR进行测试。

结果

在12周期间,TelGR的棒长度平均增加了65毫米。:与刚性棒相比,TelGR在LB和AR RoM方面显示出明显增加的运动。FE RoM方面未发现差异。

讨论

本研究结果显示,用TelGR固定的脊柱出现了预期的骨骼生长。AR和LB中RoM增加的结果表明,TelGR系统可能比传统生长棒的刚性小。如果在临床环境中证明有效,与传统生长棒相比,TelGR治疗可能会减少重复手术干预的需求。本研究增加了检验引导生长技术的有限生物力学证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdba/6686829/383eac4bdc1e/JSP2-1-e1035-g001.jpg

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