青少年特发性脊柱侧凸（AIS）患者经哈林顿棒器械治疗或支具治疗 25 年后的血清金属离子水平。
Serum metal ion levels in adolescent idiopathic scoliosis (AIS) patients 25 years after treated with Harrington rod instrumentation or bracing.
机构信息
Center for Spine Surgery and Research, Middelfart Hospital, Østre Hougvej 55, 5500, Middelfart, Denmark.
Department of Clinical Biochemistry and Immunology, Lillebaelt Hospital, Vejle, Denmark.
出版信息
Spine Deform. 2021 Nov;9(6):1519-1523. doi: 10.1007/s43390-021-00365-9. Epub 2021 May 25.
INTRODUCTION
Surgical instrumentation in children with adolescent idiopathic scoliosis (AIS) is performed early in life and the implants are left in situ for the rest of the patient's life. Concern has been raised regarding persistent elevated levels of serum metal ions, but only a few studies on the topic have been published. The aim of this study was to compare the levels of serum metal ions in patients with AIS treated with either Harrington rod instrumentation or bracing.
MATERIALS AND METHODS
AIS patients treated with Boston brace (BB) or posterior spinal fusion with Harrington rod instrumentation (HR) from 1983 to 1990 were requested to return to clinic. One hundred fifty-nine (73%) of 219 patients were available for follow-up of whom 115 agreed to have a blood draw.
RESULTS
The proportion of patients who agreed to have a blood draw were similar in the BB (48 of 100, 48%) and HR (67 of 115, 60%, p = 0.085) groups. None of the surgical patients had their implants removed; mean age at follow-up (BB: 43.2 years vs HR: 43.5 years, p = 0.566) and mean length of follow-up (BB: 26.5 years vs HR: 24.5 years). Mean chromium serum levels were similar between the BB (2.7 nmol/L) and the HR (2.9 nmol/L, p = 0.827). Mean Cobalt serum levels were also similar between the BB (2.6 nmol/L) and the HR (2.8 nmol/L, p = 0.200).
CONCLUSION
Serum metal ions were similar in AIS patients treated with bracing or Harrington rod instrumentation 25 years after initiation of treatment.
介绍
在青少年特发性脊柱侧凸（AIS）患儿中进行的外科器械操作发生在生命早期，植入物在患者的余生中都留在原位。人们对持续存在的血清金属离子升高水平表示担忧，但关于该主题的研究仅有少数几篇。本研究的目的是比较接受 Boston 支具（BB）或后路脊柱融合 Harrington 棒器械（HR）治疗的 AIS 患者的血清金属离子水平。
材料与方法
从 1983 年至 1990 年，我们邀请接受 Boston 支具（BB）或后路脊柱融合 Harrington 棒器械（HR）治疗的 AIS 患者返回诊所。219 名患者中有 159 名（73%）可进行随访，其中 115 名同意进行采血。
结果
在 BB（100 名中的 48 名，48%）和 HR（115 名中的 67 名，60%，p=0.085）组中，同意采血的患者比例相似。没有接受手术的患者将植入物取出；随访时的平均年龄（BB：43.2 岁 vs HR：43.5 岁，p=0.566）和平均随访时间（BB：26.5 年 vs HR：24.5 年）。BB（2.7 nmol/L）和 HR（2.9 nmol/L，p=0.827）之间的血清铬水平相似。BB（2.6 nmol/L）和 HR（2.8 nmol/L，p=0.200）之间的血清钴水平也相似。
结论
在开始治疗 25 年后，接受支具或 Harrington 棒器械治疗的 AIS 患者的血清金属离子水平相似。
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