The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.
University of Birmingham, Birmingham, UK.
Bone Joint J. 2022 Feb;104-B(2):257-264. doi: 10.1302/0301-620X.104B2.BJJ-2021-1198.R1.
The aim of this study was to compare the clinical and radiological outcomes of patients with early-onset scoliosis (EOS), who had undergone spinal fusion after distraction-based spinal growth modulation using either traditional growing rods (TGRs) or magnetically controlled growing rods (MCGRs).
We undertook a retrospective review of skeletally mature patients who had undergone fusion for an EOS, which had been previously treated using either TGRs or MCGRs. Measured outcomes included sequential coronal T1 to S1 height and major curve (Cobb) angle on plain radiographs and any complications requiring unplanned surgery before final fusion.
We reviewed 43 patients (63% female) with a mean age of 6.4 years (SD 2.6) at the index procedure, and 12.2 years (SD 2.2) at final fusion. Their mean follow-up was 8.1 years (SD 3.4). A total of 16 patients were treated with MCGRs and 27 with TGRs. The mean number of distractions was 7.5 in the MCGR group and ten in the TGR group (p = 0.471). The mean interval between distractions was 3.4 months in the MCGR group and 8.6 months in the TGR group (p < 0.001). The mean Cobb angle had improved by 25.1° in the MCGR group and 23.2° in TGR group (p = 0.664) at final follow-up. The mean coronal T1 to S1 height had increased by 16% in the MCGR group and 32.9% in TGR group (p = 0.001), although the mean T1 to S1 height achieved at final follow-up was similar in both. Unplanned operations were needed in 43.8% of the MCGR group and 51.2% of TGR group (p = 0.422).
In this retrospective, single-centre review, there were no significant differences in major curve correction or gain in spinal height at fusion. Although the number of planned procedures were fewer in patients with MCGRs, the rates of implant-related complications needing unplanned revision surgery were similar in the two groups. Cite this article: 2022;104-B(2):257-264.
本研究旨在比较采用传统生长棒（TGRs）或磁控生长棒（MCGRs）行脊柱撑开式生长调控后行脊柱融合术治疗的早发性脊柱侧凸（EOS）患者的临床和影像学结果。
我们回顾性分析了接受 TGRs 或 MCGRs 治疗的 EOS 患者，这些患者在骨骼成熟后接受了融合术。测量结果包括脊柱全长正位 T1 至 S1 高度和主弯（Cobb）角，以及在最终融合前需要计划外手术的任何并发症。
我们共回顾了 43 例（63%为女性）患者，索引手术时的平均年龄为 6.4 岁（标准差 2.6），最终融合时的平均年龄为 12.2 岁（标准差 2.2）。平均随访时间为 8.1 年（标准差 3.4）。16 例患者接受 MCGR 治疗，27 例患者接受 TGR 治疗。MCGR 组的平均撑开次数为 7.5 次，TGR 组为 10 次（p = 0.471）。MCGR 组的平均撑开间隔为 3.4 个月，TGR 组为 8.6 个月（p < 0.001）。MCGR 组最终随访时 Cobb 角改善 25.1°，TGR 组改善 23.2°（p = 0.664）。MCGR 组的冠状位 T1 至 S1 高度增加了 16%，TGR 组增加了 32.9%（p = 0.001），尽管最终随访时两组的 T1 至 S1 高度相似。MCGR 组和 TGR 组分别有 43.8%和 51.2%的患者需要计划外手术（p = 0.422）。
在这项回顾性、单中心研究中，两组患者的主弯矫正程度或融合时脊柱高度的增加均无显著差异。虽然 MCGR 组的计划手术次数较少，但两组因植入物相关并发症需要计划外翻修手术的发生率相似。
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