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磁控生长棒与传统生长棒技术治疗早发性脊柱侧弯矢状面效果比较

Comparison of the Effects of Magnetically Controlled Growing Rod and Tradiotinal Growing Rod Techniques on the Sagittal Plane in the Treatment of Early-Onset Scoliosis.

作者信息

Erdoğan Sinan, Polat Barış, Atıcı Yunus, Özyalvaç Osman Nuri, Öztürk Çağatay

机构信息

Department of Orthopedics and Traumatology, Baltalimanı Bone and Joint Diseases Training and Research Hospital, Istanbul, Turkey.

Department of Orthopedics and Traumatology, University of Kyrenia, Kyrenia, Turkish Republic of Northern Cyprus.

出版信息

J Korean Neurosurg Soc. 2019 Sep;62(5):577-585. doi: 10.3340/jkns.2019.0094. Epub 2019 Aug 30.

Abstract

OBJECTIVE

Comparing the effects of magnetically controlled growing rod (MCGR) and traditional growing rod (TGR) techniques on the sagittal plane in the treatment of early-onset scoliosis (EOS).

METHODS

Twelve patients were operated using dual MCGR technique in one center, while 15 patients were operated using dual TGR technique for EOS in another center. Patients' demographic characteristics, complications and radiological measurements such as cobb angle, thoracic kyphosis, lumbar lordosis, T1-S1 range (mm), proximal junctional angle, distal junctional angle, sagittal balance, coronal balance, pelvic incidence, sacral slope and pelvic tilt were assessed and compared in preoperative, postoperative and last follow-up period.

RESULTS

Age and sex distributions were similar in both groups. The mean number of lengthening in the MCGR group was 12 (8-15) and 4.8 (3-7) in the TGR group. Two techniques were shown to be effective in controlling the curvature and in the increase of T1-S1 distance. In TGR group, four patients had rod fractures, six patients had screw pull-out and four patients had an infection, whereas three patients had screw pull-out and one patient had infection complications in the MCGR group.

CONCLUSION

There was no significant difference between the two groups in terms of cobb angle, coronal and sagittal balance and sagittal pelvic parameters. MCGR can cause hypokyphosis and proximal junctional kyphosis in a minimum 2-year follow-up period. The implant-related complications were less in the MCGR group. However, larger case groups and longer follow-up periods are required for the better understanding of the superiority of one method on other in terms of complications.

摘要

目的

比较磁控生长棒(MCGR)技术和传统生长棒(TGR)技术在早发性脊柱侧弯(EOS)矢状面治疗中的效果。

方法

在一个中心,12例患者采用双MCGR技术进行手术,而在另一个中心,15例患者采用双TGR技术治疗EOS。评估并比较两组患者术前、术后及末次随访时的人口统计学特征、并发症以及放射学测量指标,如 Cobb 角、胸椎后凸、腰椎前凸、T1-S1 长度(mm)、近端交界角、远端交界角、矢状面平衡、冠状面平衡、骨盆入射角、骶骨倾斜度和骨盆倾斜度。

结果

两组患者的年龄和性别分布相似。MCGR组平均延长次数为12次(8 - 15次),TGR组为4.8次(3 - 7次)。两种技术在控制脊柱侧弯和增加T1-S1距离方面均显示有效。TGR组有4例患者发生棒体骨折,6例患者出现螺钉拔出,4例患者发生感染;而MCGR组有3例患者出现螺钉拔出,1例患者出现感染并发症。

结论

两组在Cobb角、冠状面和矢状面平衡以及骨盆矢状面参数方面无显著差异。在至少2年的随访期内,MCGR可导致后凸不足和近端交界性后凸。MCGR组与植入物相关的并发症较少。然而,为了更好地了解一种方法在并发症方面相对于另一种方法的优势,需要更大的病例组和更长的随访期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad6f/6732347/8782e4d839cd/jkns-2019-0094f1.jpg

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