Jackie and Gene Autry Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop #69, Los Angeles, CA, 90027, USA.
School of Public Health, LSU Health Sciences Center, New Orleans, LA, USA.
Spine Deform. 2024 Jul;12(4):1145-1153. doi: 10.1007/s43390-024-00842-x. Epub 2024 Mar 21.
This purpose of this study was to assess the impact of patient and implant characteristics on LIV selection in ambulatory children with EOS and to assess the relationship between the touched vertebrae (TV), the last substantially touched vertebrae (LSTV), the stable vertebrae (SV), the sagittal stable vertebrae (SSV), and the LIV.
A multicenter pediatric spine database was queried for patients ages 2-10 years treated by growth friendly instrumentation with at least 2-year follow up. The relationship between the LIV and preoperative spinal height, curve magnitude, and implant type were assessed. The relationships between the TV, LSTV, SV, SSV, and the LIV were also evaluated.
Overall, 281 patients met inclusion criteria. The LIV was at L3 or below in most patients with a lumbar LIV: L1 (9.2%), L2 (20.2%), L3 (40.9%), L4 (29.5%). Smaller T1 - T12 length was associated with more caudal LIV selection (p = 0.001). Larger curve magnitudes were similarly associated with more caudal LIV selection (p = < 0.0001). Implant type was not associated with LIV selection (p = 0.32) including MCGR actuator length (p = 0.829). The LIV was caudal to the TV in 78% of patients with a TV at L2 or above compared to only 17% of patients with a TV at L3 or below (p < 0.0001).
Most EOS patients have an LIV of L3 or below and display TV-LIV and LSTV-LIV incongruence. These findings suggest that at the end of treatment, EOS patients rarely have the potential for selective thoracic fusion. Further work is necessary to assess the potential for a more selective approach to LIV selection in EOS.
III.
本研究旨在评估在患有特发性脊柱侧凸的门诊患儿中，患者和植入物特征对 LIV 选择的影响，并评估触及椎体 (TV)、最后触及的稳定椎体 (LSTV)、稳定椎体 (SV)、矢状面稳定椎体 (SSV) 和 LIV 之间的关系。
通过对至少有 2 年随访的采用生长友好型器械治疗的 2-10 岁患儿的多中心儿科脊柱数据库进行查询，评估 LIV 与术前脊柱高度、曲线幅度和植入物类型的关系。还评估了 TV、LSTV、SV、SSV 与 LIV 之间的关系。
总体而言，281 名患者符合纳入标准。大多数患者的 LIV 在 L3 或以下，腰椎 LIV：L1（9.2%）、L2（20.2%）、L3（40.9%）、L4（29.5%）。T1-T12 长度越小，LIV 选择越靠下（p=0.001）。较大的曲线幅度也与 LIV 选择越靠下相关（p<0.0001）。植入物类型与 LIV 选择无关（p=0.32），包括 MCGR 执行器长度（p=0.829）。TV 在 L2 或以上的患者中，LIV 在 TV 以下的占 78%，而 TV 在 L3 或以下的患者中仅占 17%（p<0.0001）。
大多数 EOS 患者的 LIV 在 L3 或以下，并且存在 TV-LIV 和 LSTV-LIV 不一致。这些发现表明，在治疗结束时，EOS 患者很少有选择性胸椎融合的潜力。需要进一步的工作来评估在 EOS 中对 LIV 选择更具选择性方法的潜力。
III。
