Hurry Jennifer, Brown John-David, Bansal Ankita, Al Amer Abdullah, Boachie-Adjei Oheneba, Vitale Michael, Pahys Joshua, Luhmann Scott, El-Hawary Ron
Division of Orthopedic Surgery, IWK Health Centre, 5850 University Avenue, P.O. Box 9700, Halifax, NS, B3K6R8, Canada.
Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
Spine Deform. 2025 Mar;13(2):639-645. doi: 10.1007/s43390-024-01008-5. Epub 2024 Nov 19.
To determine, at 2 year follow-up, 3D spine growth for idiopathic early onset scoliosis (iEOS) patients treated with magnetically controlled growing rods (MCGR).
From an international EOS registry, patients with iEOS treated with MCGR were identified. Scoliosis, kyphosis, traditional coronal height, and 3D true spine length (3D-TSL) were measured pre-index surgery, post-index, and at 2 year follow-up.
135 participants, mean age 8.1 years (2.7-15.6) were included. Scoliosis improved from 71° pre-index to 41° post-index (p < 0.001) and remained constant at 2 years (43°, p = 0.58). Kyphosis improved from 49° to 36° (p < 0.001); then increased by 2 years to 42° (p = 0.002). Traditional T1-S1 height, which reflects both spine growth and changes in deformity, increased from pre-index to post-index (274 mm vs. 310 mm; p < 0.001), and again at 2 years (332 mm, p < 0.001). As 3D-TSL reflects growth of the spine, independent of changes in deformity, as expected it did not change perioperatively (335 mm vs. 339 mm, p = 0.83), but significantly changed by 2 years (367 mm; p < 0.001). Participants < 5 years at surgery increased 22 mm (8.2%), 5-10 years increased 26 mm (7.8%), and > 10 increased 41 mm (11.0%). For instrumented levels, mean vertebral growth was 1.3 mm/level for < 5 years, 1.4 mm/level for 5-10 years, and 2.2 mm/level for > 10 years.
As kyphosis increased over time, these out of the coronal plane changes justify the use of 3D-TSL for this cohort of patients. For idiopathic EOS patients treated with MCGR, 3D spine length increased by 28 mm during the 2 year post-operative period.
在2年随访期内，确定接受磁控生长棒（MCGR）治疗的特发性早发性脊柱侧凸（iEOS）患者的三维脊柱生长情况。
从一个国际早发性脊柱侧凸登记处，识别出接受MCGR治疗的iEOS患者。在首次手术前、首次手术后以及2年随访时测量脊柱侧凸、后凸、传统冠状面高度和三维真实脊柱长度（3D-TSL）。
纳入135名参与者，平均年龄8.1岁（2.7 - 15.6岁）。脊柱侧凸从首次手术前的71°改善至首次手术后的41°（p < 0.001），并在2年时保持稳定（43°，p = 0.58）。后凸从49°改善至36°（p < 0.001）；然后在2年时增加至42°（p = 0.002）。反映脊柱生长和畸形变化的传统T1 - S1高度，从首次手术前到首次手术后增加（274mm对310mm；p < 0.001），在2年时再次增加（332mm，p < 0.001）。由于3D-TSL反映脊柱生长且不受畸形变化影响，正如预期，其在围手术期未发生变化（335mm对339mm，p = 0.83），但在2年时显著增加（367mm；p < 0.001）。手术时年龄<5岁的参与者增加了22mm（8.2%），5 - 10岁的增加了26mm（7.8%），>10岁的增加了41mm（11.0%）。对于置入器械的节段，<5岁者平均椎体生长为1.3mm/节段，5 - 10岁者为1.4mm/节段，>10岁者为2.2mm/节段。
随着时间推移后凸增加，这些冠状面外的变化证明了对该队列患者使用3D-TSL的合理性。对于接受MCGR治疗的特发性早发性脊柱侧凸患者，术后2年内三维脊柱长度增加了28mm。
