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接受椎体束缚与后路脊柱融合治疗青少年特发性脊柱侧凸的患者报告结局相当。

Patient-Reported Outcomes Are Equivalent in Patients Who Receive Vertebral Body Tethering Versus Posterior Spinal Fusion in Adolescent Idiopathic Scoliosis.

出版信息

Orthopedics. 2021 Jan 1;44(1):24-28. doi: 10.3928/01477447-20201119-02. Epub 2020 Nov 25.

Abstract

Anterior vertebral body tethering (AVBT), or spinal growth tethering, is an emerging technology that recently received Food and Drug Administration (FDA) approval through a humanitarian device exemption designation to treat idiopathic scoliosis patients with remaining growth. This study compared patients who underwent AVBT with those treated with standard-of-care posterior spinal fusion (PSF) to determine inherent differences in patients and families who seek cutting-edge treatments. The authors reviewed 62 PSF patients from a multicenter registry and 20 AVBT patients from an FDA-approved investigational clinical trial. The authors examined demographics, preoperative clinical and radiographic variables, and health-related quality of life (HRQOL). All included patients preoperatively were classified as Lenke type 1 or 2 with a thoracic curve of 35° to 60°, a lumbar curve less than 35°, and a skeletal maturity score of Risser sign 0 or Sanders bone age of 4 or less. Idiopathic scoliosis patients treated with surgical intervention were primarily White females who were 12 years old. No differences in demographics, clinical variables, and radiographic measures were detected between the PSF and AVBT cohorts. The AVBT group showed more thoracic flexibility on bending radiographs, correcting on average 59% compared with 43% for PSF patients (P=.005). Patients had similar HRQOL total scores and scores across each of the 5 domains of the Scoliosis Research Society Questionnaire Version 22. The percentage of patients scoring below 4.0 within each domain was comparable between cohorts. Scoliosis patients who underwent vertebral tethering at a level of deformity magnitude and maturity similar to those who underwent posterior fusion did not differ at baseline regarding demographics, clinical variables, and HRQOL. [Orthopedics. 2021;44(1):24-28.].

摘要

前路椎体束缚术(AVBT)或脊柱生长束缚术是一种新兴技术,最近通过人道主义设备豁免指定获得了食品和药物管理局(FDA)的批准,用于治疗有剩余生长潜力的特发性脊柱侧凸患者。本研究比较了接受 AVBT 的患者与接受标准后脊柱融合术(PSF)治疗的患者,以确定寻求前沿治疗的患者和家庭之间的固有差异。作者回顾了来自多中心登记处的 62 例 PSF 患者和来自 FDA 批准的临床试验的 20 例 AVBT 患者。作者检查了人口统计学、术前临床和影像学变量以及健康相关生活质量(HRQOL)。所有纳入的患者术前均被分类为 Lenke 型 1 或 2 型,胸弯 35°至 60°,腰弯小于 35°,骨骼成熟度评分 Risser 征 0 或 Sanders 骨龄 4 或更小。接受手术干预的特发性脊柱侧凸患者主要为白人女性,年龄 12 岁。PSF 和 AVBT 队列之间在人口统计学、临床变量和影像学测量方面没有差异。AVBT 组在弯曲位 X 线片上显示出更多的胸椎灵活性,平均矫正 59%,而 PSF 患者为 43%(P=.005)。患者的 SRS-22 问卷总分和每个 5 个领域的分数相似。每个领域评分低于 4.0 的患者百分比在队列之间具有可比性。在畸形程度和成熟度与接受后路融合术相似的脊柱侧凸患者中,接受椎体束缚术的患者在基线时在人口统计学、临床变量和 HRQOL 方面没有差异。[骨科。2021;44(1):24-28.]。

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