Shetty Ajoy Prasad, Nikhil Kadanthode Vasu, Renjith Karukayil Ramakrishnan, Vijayanand K S Sri, Kanna P Rishi Mukesh, Rajasekaran Shanmuganathan
Department of Spine Surgery, Ganga Medical Centre & Hospital Pvt Ltd, Mettupalayam Rd, Saibaba Koil, Coimbatore, Tamil Nadu, India 641043.
Department of Spine Surgery, Ganga Medical Centre & Hospital Pvt Ltd, Mettupalayam Rd, Saibaba Koil, Coimbatore, Tamil Nadu, India 641043.
Spine Deform. 2019 Nov;7(6):979-984. doi: 10.1016/j.jspd.2019.03.009.
Retrospective.
To compare outcomes and complications of all-pedicle screw against hybrid constructs as proximal anchors in traditional growth rod technique.
Traditional distraction-based growth rods, although the preferred technique in treating progressive curves in early-onset scoliosis (EOS) is not free from complications. Surgical outcome and implant-related complications can be influenced by the choice of construct, but there is a paucity of evidence in literature comparing different constructs with these techniques.
A retrospective review was performed of 28 consecutive patients with progressive EOS treated between 2009 and 2015 with growth rod technique. Patients were divided into two groups; Standard group (SG), where all pedicle screw construct was used; and Hybrid group (HG), where proximal rib hooks and distal pedicle screws were used. Pre- and postoperative clinical and radiologic parameters and complications were recorded and compared.
There were 13 patients (8 females, 5 males) in SG and 15 patients (13 females, 2 males) in HG. There was statistically significant improvement in scoliosis correction and length gain after initial surgery in both groups, where patients in SG showed better correction than HG. However, neither the radiologic parameters nor the complication rates showed any statistically significant difference between the two groups.
Data from our study indicate that the proximal anchors, whether spine-based or rib-based, do not differ much in their outcome and complication rates, and the success of growing-rod technique depends largely on the security of cephalad and caudal foundations.
Level IV.
回顾性研究。
比较在传统生长棒技术中，全椎弓根螺钉与混合结构作为近端固定点的治疗效果及并发症情况。
传统的撑开式生长棒，尽管是治疗早发性脊柱侧凸（EOS）进展性侧弯的首选技术，但并非没有并发症。手术效果和与植入物相关的并发症可能会受到固定结构选择的影响，但文献中缺乏比较这些技术中不同固定结构的证据。
对2009年至2015年间连续28例采用生长棒技术治疗的进展性EOS患者进行回顾性研究。患者分为两组；标准组（SG），采用全椎弓根螺钉固定结构；混合组（HG），采用近端肋骨钩和远端椎弓根螺钉。记录并比较术前、术后的临床和影像学参数及并发症情况。
SG组有13例患者（8例女性，5例男性），HG组有15例患者（13例女性，2例男性）。两组初次手术后脊柱侧凸矫正和长度增加均有统计学意义上的显著改善，SG组患者的矫正效果优于HG组。然而，两组的影像学参数和并发症发生率均无统计学意义上的显著差异。
我们的研究数据表明，近端固定点，无论是基于脊柱的还是基于肋骨的，在治疗效果和并发症发生率方面差异不大，生长棒技术的成功很大程度上取决于头端和尾端基础的稳固性。
四级。
