Zagazig University, Zagazig, Egypt.
IWK Health Centre, Halifax, NS, Canada.
Spine Deform. 2021 Mar;9(2):603-608. doi: 10.1007/s43390-020-00230-1. Epub 2020 Oct 29.
Karol et al. introduced the concept that 18 cm thoracic height is the critical point where a patient with early onset scoliosis (EOS) can maintain adequate pulmonary function. Our purpose was to determine if distraction-based surgeries will increase thoracic spine height to at least 18 cm in patients with EOS.
Patients with EOS treated with distraction-based systems (minimum 5 years follow up, minimum five lengthenings). Radiographic analysis of thoracic spine height (T1-T12) at the last lengthening procedure.
One hundred and fifty-three patients (67 congenital, 21 neuromuscular, 38 syndromic, 27 idiopathic) with pre-operative mean age 4.6 years, scoliosis 75°, kyphosis 47° were evaluated. Their mean age at final lengthening procedure was 11 years (6-16), average number of lengthening procedures was 10.5 (4-21), mean final scoliosis was 53°, and mean final kyphosis was 58°. Final thoracic height was > 18 cm in 65% and was > 22 cm in 31% of patients. Based on etiology, only 48% of the congenital patients reached 18 cm compared to 81% neuromuscular, 84% syndromic and 67% idiopathic. This height gain was closely related to the percentage of scoliosis correction achieved for each etiology. Comparing congenital etiology to other etiologies, there was a lower percentage of patients in the congenital group that passed the 18 cm threshold (48% vs. 78%) (p < 0.05).
At minimum 5 years follow up, distraction-based surgeries increased thoracic height for patients with EOS to greater than 18 cm in 65% of patients; however, only 48% of congenital patients reached this thoracic height threshold.
Retrospective review of prospectively collected registry data. LOI III.
Karol 等人提出了 18cm 胸椎高度是早发性脊柱侧凸（EOS）患者能够维持足够肺功能的临界点的概念。我们的目的是确定基于牵引的手术是否会使 EOS 患者的胸椎高度至少增加到 18cm。
对采用基于牵引的系统治疗的 EOS 患者（至少 5 年随访，至少 5 次延长）进行分析。在最后一次延长手术时进行胸椎高度（T1-T12）的影像学分析。
对 153 例患者（67 例先天性、21 例神经肌肉型、38 例综合征型、27 例特发性）进行了评估，这些患者术前平均年龄为 4.6 岁，脊柱侧凸 75°，后凸 47°。他们在最后一次延长手术时的平均年龄为 11 岁（6-16 岁），平均延长手术次数为 10.5 次（4-21 次），平均最终脊柱侧凸为 53°，平均最终后凸为 58°。65%的患者最终胸椎高度>18cm，31%的患者最终胸椎高度>22cm。根据病因，只有 48%的先天性患者达到 18cm，而神经肌肉型、综合征型和特发性患者分别为 81%、84%和 67%。这种身高增长与每种病因的脊柱侧凸矫正百分比密切相关。与其他病因相比，先天性病因组中通过 18cm 阈值的患者比例较低（48%对 78%）（p<0.05）。
在至少 5 年的随访中，基于牵引的手术使 EOS 患者的胸椎高度增加到大于 18cm，在 65%的患者中；然而，只有 48%的先天性患者达到了这个胸椎高度阈值。
前瞻性收集登记数据的回顾性研究。LOI III。
