Department of Orthopaedics, Mardin Kızıltepe State Hospital, Mardin, Turkey.
Department of Orthopaedics, Istanbul Medeniyet University Goztepe Education and Research Hospital, Istanbul, Turkey.
World Neurosurg. 2020 Sep;141:e844-e850. doi: 10.1016/j.wneu.2020.06.045. Epub 2020 Jun 12.
Distraction-based systems are the most common systems used in the treatment of early-onset scoliosis. In addition to its corrective and deformity progression preventive properties, its vertebral growth stimulation effect has been proved. Recently popularized magnetically controlled growing rods (MCGRs) showed superior results in terms of outcomes and decreased complication rate. Its vertebral growth stimulation effect has not been studied. The aim of the study is to evaluate the vertebral growth stimulation effect in patients treated with MCGR.
Patients with progressive scoliosis treated by dual MCGR, who had no obvious lumbar vertebral deformity and had a regular 3-month interval spinal lengthening for at least 30 months, were subdivided into 2 groups according to the inclusion of L3 vertebra within instrumentation segments. The L3 vertebral vertical and horizontal lengths were measured postoperatively and at the last follow-up, and their differences were analyzed statistically in both groups.
Twenty-four patients were included; 18 of them had an L3 vertebra outside instrumentation segments, while the other 6 had spanned by MCGR. Uninstrumented L3 were followed up for an average of 36 months. The height difference between initial postoperative examination and the last follow-up was 3.55 mm ± 0.63 mm, and the width difference was 3.85 mm ± 0.75 mm. Conversely, patients with instrumented L3 were followed up for a mean of 38.9 months. Their initial postoperative examination and last follow-up differences in height and width were 6.91 mm ± 1.11 mm and 3.66 mm ± 0.92 mm, respectively.
Frequent distractions stimulate longitudinal vertebral growth in vertebrae spanned by MCGR.
分散式系统是治疗早期特发性脊柱侧凸最常用的系统。除了具有矫正和防止畸形进展的特性外，其还具有刺激椎体生长的作用。最近流行的磁控生长棒（MCGR）在疗效和降低并发症发生率方面表现出了更好的效果。但其对椎体生长的刺激作用尚未得到研究。本研究旨在评估 MCGR 治疗患者的椎体生长刺激作用。
对接受双 MCGR 治疗的进展性脊柱侧凸患者进行研究，这些患者无明显腰椎侧凸畸形，且至少每隔 3 个月进行 1 次脊柱延长，每次延长间隔 30 个月。根据器械节段内是否包含 L3 椎体，将患者分为 2 组。术后和末次随访时测量 L3 椎体的垂直和水平长度，并对两组进行统计学分析。
共纳入 24 例患者，其中 18 例 L3 椎体位于器械节段外，6 例 L3 椎体被 MCGR 覆盖。未行器械固定的 L3 椎体平均随访 36 个月。初始术后检查与末次随访时的高度差为 3.55mm±0.63mm，宽度差为 3.85mm±0.75mm。相反，行器械固定 L3 椎体的患者平均随访 38.9 个月。其初始术后检查与末次随访时的高度和宽度差值分别为 6.91mm±1.11mm和 3.66mm±0.92mm。
频繁的撑开刺激了 MCGR 覆盖的椎体的纵向生长。
