Navarro-Ramirez Rodrigo, Rabau Oded, Teles Alisson, Ge Susan, Shebreen Abdulaziz Bin, Saran Neil, Ouellet Jean
Spine Surgery and Scoliosis Group, McGill University Health Centre, Montreal, Quebec, Canada.
Neurosurg Focus Video. 2020 Jan 1;2(1):V9. doi: 10.3171/2020.1.FocusVid.19683. eCollection 2020 Jan.
Early-onset scoliosis (EOS) correction techniques have evolved slowly over the past 40 years and still remain a challenge for the spine surgeon. Avoiding spinal fusion in these patients is key to decreasing morbidity and mortality in this population. Current treatments for EOS include both conservative and surgical options. The authors present the modified Luqué technique that has been performed at their institution for the past decade. This modified technique relies on Luqué's principle, but with newer "gliding" implants through a less disruptive approach. The goal of this technique is to delay fusion as long as possible, with the intent to prevent deformity progression while preserving maximal growth. Normally, these patients will have definitive fusion surgery once they have reached skeletal maturity or as close as possible. Out of 23 patients until present (close to 4-year follow-up), the authors have not performed any revision due to implant failure. Three patients have undergone final fusion as the curve progressed (one patient, 4 years out, had final fusion at age 12 years; two other patients had final fusion at 3 years). These implants, which have the CE mark in Europe, are available in Canada via a special access process with Health Canada. The implants have not yet been submitted to the FDA, as they are waiting on clinical data out of Europe and Canada. In the following video the authors describe the modified Luqué technique step-by-step. The video can be found here: https://youtu.be/k0AuFa9lYXY.
早发性脊柱侧凸（EOS）矫正技术在过去40年中发展缓慢，对脊柱外科医生来说仍然是一项挑战。在这些患者中避免脊柱融合是降低该人群发病率和死亡率的关键。目前EOS的治疗方法包括保守治疗和手术治疗。作者介绍了他们机构在过去十年中采用的改良Luqué技术。这种改良技术依赖于Luqué的原理，但采用了更新的“滑动”植入物，手术入路的干扰性更小。该技术的目标是尽可能长时间地推迟融合，以防止畸形进展，同时保留最大程度的生长。通常，这些患者一旦达到骨骼成熟或尽可能接近骨骼成熟时，将接受确定性融合手术。到目前为止，在23例患者中（接近4年随访），作者尚未因植入物失败而进行任何翻修手术。有3例患者因侧弯进展而接受了最终融合手术（1例患者在4年后，12岁时接受了最终融合手术；另外2例患者在3岁时接受了最终融合手术）。这些在欧洲有CE标志的植入物，在加拿大可通过加拿大卫生部的特殊准入程序获得。由于正在等待来自欧洲和加拿大的临床数据，这些植入物尚未提交给美国食品药品监督管理局（FDA）。在下面的视频中，作者逐步介绍了改良Luqué技术。视频可在此处找到：https://youtu.be/k0AuFa9lYXY 。
