Lippross Sebastian, Girmond Paul, Lüders Katja A, Austein Friederike, Braunschweig Lena, Lüders Stefan, Tsaknakis Konstantinos, Lorenz Heiko M, Hell Anna K
Department of Trauma, Orthopedic and Plastic Surgery, University Medical Center Goettingen, 37075 Goettingen, Germany.
Department of Orthopedic and Trauma Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany.
J Clin Med. 2021 May 14;10(10):2124. doi: 10.3390/jcm10102124.
In recent decades, magnetically controlled growing rods (MCGR) were established to treat progressive early-onset scoliosis. The aim of this investigation was to assess the effect of long-term MCGR with continuous distraction on intervertebral discs in scoliotic children. Magnetic resonance imaging (MRI) of 33 children with spinal muscular atrophy was analyzed by grading intervertebral disc degeneration (IDD) and measuring intervertebral disc volume. Cohort I ( = 17) were children who had continuous spinal distraction with MCGRs for 5.1 years and MRI before (av. age 8.1) and after (av. age 13.4) MCGR treatment. Cohort II ( = 16, av. age 13.7) were patients without prior surgical treatment. Lumbar intervertebral disc volume of cohort I did not change during 5.1 years of MCGR treatment, whereas disc volumes were significantly larger in age- and disease-matched children without prior treatment (cohort II). Cohort I showed more IDD after MCGR treatment in comparison to early MRI studies of the same patients and children without surgical treatment. MRI data showed a volume reduction and disc degeneration of lower thoracic and lumbar intervertebral discs in scoliotic children after continuous spinal distraction with MCGRs. These effects were confirmed in the same subjects before and after treatment as well as in surgically untreated controls.
近几十年来,磁控生长棒(MCGR)被用于治疗早发性进行性脊柱侧弯。本研究的目的是评估长期使用MCGR持续撑开对脊柱侧弯患儿椎间盘的影响。通过对椎间盘退变(IDD)进行分级并测量椎间盘体积,分析了33例脊髓性肌萎缩症患儿的磁共振成像(MRI)。第一组(n = 17)是使用MCGR持续脊柱撑开5.1年的患儿,在MCGR治疗前(平均年龄8.1岁)和治疗后(平均年龄13.4岁)均进行了MRI检查。第二组(n = 16,平均年龄13.7岁)是未接受过手术治疗的患者。在MCGR治疗的5.1年期间,第一组患儿的腰椎间盘体积没有变化,而在年龄和疾病匹配的未接受过治疗的患儿(第二组)中,椎间盘体积明显更大。与同一患者早期的MRI研究以及未接受手术治疗的患儿相比,第一组患儿在MCGR治疗后显示出更多的IDD。MRI数据显示,在使用MCGR持续脊柱撑开后,脊柱侧弯患儿的下胸段和腰椎间盘体积减小且出现椎间盘退变。这些影响在治疗前后的同一受试者以及未接受手术治疗的对照中均得到证实。