Department of Spinal Surgery, Royal Orthopaedic Hospital, Bristol Road South, Birmingham, B31 2AP, UK.
Spine Deform. 2021 Jul;9(4):1169-1174. doi: 10.1007/s43390-021-00295-6. Epub 2021 Feb 1.
Surgical treatment of Early Onset Scoliosis (EOS) is challenging. Stable and robust foundations are vital. We have assessed a small cohort of patients with a rib-based proximal fixation and a pedicle screw-based distal foundation for a distraction based growing rod system.
This is a single center study in a tertiary spinal deformity unit with a catchment population of over 6 million. We performed a retrospective radiographic evaluation of 15 patients with EOS treated with Vertical Expandable Titanium Prosthetic Rib (VEPTR) implant between 2007 and 2017. The review of medical records and imaging data was performed to identify growth of the spine and complications with pedicle screws.
There were ten male and five female patients with an average age at index surgery of 4yrs 11 months. Mean length of follow-up was 6 yrs 9 months. Serial radiographs revealed improvements in mean Cobb angle of 12 degrees, T1-T12 height of 29 mm and T1-S1 height of 48 mm with no deterioration in distal LIV tilt angle. We report that none of these patients had any complications related to their pedicle screws including cut-out.
We report a technique which is efficacious and provides a mechanically robust distal fixation for VEPTR lengthening in early onset scoliosis.
早期发病脊柱侧凸（EOS）的手术治疗具有挑战性。稳定而坚固的基础至关重要。我们评估了一小部分患者的肋骨近端固定和椎弓根螺钉为基础的远端基础，用于基于牵引的生长棒系统。
这是一家三级脊柱畸形中心的单中心研究，其集水区人口超过 600 万。我们对 2007 年至 2017 年间接受垂直可扩张钛假体肋骨（VEPTR）植入物治疗的 15 例 EOS 患者进行了回顾性放射学评估。对病历和影像学数据进行了回顾，以确定脊柱生长和椎弓根螺钉并发症。
有 10 名男性和 5 名女性患者，索引手术时的平均年龄为 4 岁 11 个月。平均随访时间为 6 年 9 个月。连续的 X 光片显示平均 Cobb 角改善 12 度，T1-T12 高度增加 29 毫米，T1-S1 高度增加 48 毫米，而远端 LIV 倾斜角无恶化。我们报告说，这些患者均无与椎弓根螺钉相关的并发症，包括螺钉切出。
我们报告了一种有效的技术，为早期发病脊柱侧凸的 VEPTR 延长提供了机械上坚固的远端固定。
