Azmi Ahmad Alaaeldin, Aker Loai, Hanbali Yahia, Arafat Yousef
Poly Technique University-Palestine, Ramallah, West Bank, Palestine.
An-Najah National University, Nablus, Palestine.
Global Spine J. 2020 Jun;10(4):370-374. doi: 10.1177/2192568219848143. Epub 2019 May 21.
Retrospective study.
This study retrospectively evaluates the outcome of the surgical treatment of early-onset scoliosis with proximal clawing rib fixation in hybrid growing-rod constructs. The study examines spinal deformity correction with spinal growth maintenance, and the complications associated with this technique.
A hybrid rib construct surgery with serial lengthening was utilized for the treatment of 71 patients. Mean age at surgery was 66.6 months and mean time for follow-up was 43.9 months.
The coronal Cobb angle in patients fell from 63.1° preoperatively to 51.6° at the last follow-up, with a correction of 16.8%. The sagittal Cobb angle fell from 66.7° preoperatively to 38° at the last follow-up, with a correction of 42.6%. Coronal balance fell from 22.8° preoperatively to 22.3°, and sagittal balance fell from 35.4 mm preoperatively to 24.39 mm. T1-S1 spine height increased from 248.7 mm preoperatively to 282.4 mm, with a mean change of 1.13 cm per year. No neurological complications were detected.
Surgical management for early-onset scoliosis using proximal clawing rib fixation technique is a good choice in terms of safety, ease of placing the proximal anchors, ability to use more than one form of instrumentation, and a lower complication rate.
回顾性研究。
本研究回顾性评估在混合生长棒结构中采用近端爪形肋骨固定治疗早发性脊柱侧弯的手术效果。该研究考察脊柱畸形矫正及脊柱生长维持情况,以及与此技术相关的并发症。
采用带连续延长的混合肋骨结构手术治疗71例患者。手术时的平均年龄为66.6个月,平均随访时间为43.9个月。
患者的冠状面Cobb角从术前的63.1°降至末次随访时的51.6°,矫正率为16.8%。矢状面Cobb角从术前的66.7°降至末次随访时的38°,矫正率为42.6%。冠状面平衡从术前的22.8°降至22.3°,矢状面平衡从术前的35.4 mm降至24.39 mm。胸1至骶1脊柱高度从术前的248.7 mm增加至282.4 mm,平均每年变化1.13 cm。未检测到神经并发症。
就安全性、近端锚钉置入的便利性、使用多种器械的能力以及较低的并发症发生率而言,采用近端爪形肋骨固定技术治疗早发性脊柱侧弯是一个不错的选择。