Department of Pediatric Surgery, Jeanne de Flandre Hospital, Avenue Eugène Avinée, CHU Lille, 59000, Lille Cedex, France.
Orthopaedic and Reconstructive Surgery in Children, Hôpital Armand-Trousseau - AP-HP Is, 26 Avenue du Docteur Arnold Netter, 75012, Paris, France.
Eur Spine J. 2023 Jul;32(7):2558-2573. doi: 10.1007/s00586-023-07762-w. Epub 2023 May 25.
The purpose of this study was to investigate patients with early-onset scoliosis (EOS) who completed their electromagnetic lengthening rod program to assess the demographics of this population and to analyze the evolution of clinical and radiological parameters and the occurrence of complications.
This was a multicenter study with 10 French centers. We collected all patients with EOS who had undergone electromagnetic lengthening between 2011 and 2022. They had to have reached the end of the procedure (graduate).
A total of 90 graduate patients were included. The mean follow-up time over the entire period was 66 months (25.3-109). Of these, only 66 patients (73.3%) underwent definitive spinal arthrodesis at the end of the lengthening phase, whereas 24 patients (26.7%) kept their hardware in situ with a mean follow-up time from the last lengthening of 25 months (3-68). Patients had an average of 2.6 surgeries (1-5) over the entire follow-up. Patients had an average of 7.9 lengthenings for a mean total lengthening of 26.9 mm (4-75). Analysis of the radiological parameters showed a percentage reduction in the main curve of 12 to 40%, depending on the etiology, with an average reduction of 73-44°, and an average thoracic height of 210 mm (171-214) for an average improvement of 31 mm (23-43). There was no significant difference in the sagittal parameters. During the lengthening phase, there were a total of 56 complications in 43 patients (43.9%; n = 56/98), of which 39 in 28 patients (28.6%) resulted in unplanned surgery. In the graduate patients, there were a total of 26 complications in 20 patients (22.2%), all of which resulted in unscheduled surgery.
MCGR, allow to decrease the number of surgeries, to progressively improve the scoliotic deformity and to reach a satisfactory thoracic height at the price of an important complication rate linked in particular to the complexity of the management of patients with an EOS.
本研究旨在调查完成电磁延长杆治疗的早发性脊柱侧凸(EOS)患者,以评估该人群的人口统计学特征,并分析临床和影像学参数的变化以及并发症的发生情况。
这是一项多中心研究,涉及法国的 10 个中心。我们收集了 2011 年至 2022 年间接受电磁延长治疗的所有 EOS 患者。这些患者必须已完成治疗(毕业)。
共纳入 90 名毕业患者。整个研究期间的平均随访时间为 66 个月(25.3-109)。其中,只有 66 名患者(73.3%)在延长阶段结束时进行了确定性脊柱融合术,而 24 名患者(26.7%)保留了其植入物,末次延长后的平均随访时间为 25 个月(3-68)。在整个随访期间,患者平均接受了 2.6 次手术(1-5 次)。患者平均进行了 7.9 次延长,总延长长度为 26.9mm(4-75)。影像学参数分析显示,主要曲线的百分比减少了 12%至 40%,具体取决于病因,平均减少了 73-44°,平均胸高为 210mm(171-214),平均改善了 31mm(23-43)。矢状位参数无显著差异。在延长阶段,共有 43 名患者(43.9%;n=56/98)发生了 56 次并发症,其中 28 名患者(28.6%)中有 39 次并发症需要进行计划外手术。在毕业患者中,共有 20 名患者(22.2%)发生了 26 次并发症,所有并发症均需进行计划外手术。
MCGR 可减少手术次数,逐步改善脊柱侧凸畸形,并达到满意的胸高,但代价是与 EOS 患者管理的复杂性相关的高并发症发生率。