Wang Jianqiang, Geng Haoshuang, Zhou Lijin, Hai Yong
Department of Orthopaedic Surgery, Beijing Chaoyang Hospital, Capital Medical University of China, Beijing, China.
Joint Laboratory for Research & Treatment of Spinal Cord Injury in Spinal Deformity, Capital Medical University of China, Beijing, China.
Asian Spine J. 2025 Jun;19(3):399-407. doi: 10.31616/asj.2024.0426. Epub 2025 Mar 4.
Retrospective case-control study.
This study aimed to explore the relationship between the rod-lengthening interval and the incidence of postoperative complications as well as the outcomes in patients with early-onset scoliosis (EOS) undergoing growing rod surgery.
EOS is characterized by a spinal deformity that manifests before the age of 10 years. The growing rod technique allows for spinal curvature correction while preserving spinal growth through periodic lengthening surgeries typically performed every 6 months. However, we found that due to challenges, many patients undergo a 1-year or even longer interval between lengthening surgeries.
We conducted a retrospective analysis of 59 patients with EOS who underwent growing rod surgery at our institution between August 2012 and June 2022. We collected radiographic parameters to compare the differences in outcomes and complications between patients who underwent lengthening surgeries at intervals of 12 months versus those with intervals of >12 months.
In this study, we found 29 complications in 59 patients. The complication rate was significantly lower in the group with lengthening intervals of 12 months compared with the group with intervals longer than 12 months (35.3% vs. 68%, p <0.05). In addition, patients in the group with intervals of 12 months showed less progression of the main curve, a lower maximum kyphosis angle, and greater increases in height in the fixed segments (d=7.53±3.69 cm, p <0.05). In contrast, patients with lengthening intervals longer than 12 months were more likely to experience sagittal plane imbalance (p <0.05).
Lengthening intervals of greater than 12 months have a higher rate of complications and increase the risk of curve progression and spinal imbalance. Increasing the interval time just to minimize the number of surgeries before the final fusion is unwise.
回顾性病例对照研究。
本研究旨在探讨早发性脊柱侧弯（EOS）患者行生长棒手术时，延长间隔时间与术后并发症发生率以及治疗效果之间的关系。
EOS的特征是在10岁之前出现脊柱畸形。生长棒技术可在保留脊柱生长的同时矫正脊柱侧弯，通常每6个月进行一次定期延长手术。然而，我们发现由于存在挑战，许多患者在延长手术之间间隔1年甚至更长时间。
我们对2012年8月至2022年6月期间在本机构接受生长棒手术的59例EOS患者进行了回顾性分析。我们收集了影像学参数，以比较间隔12个月进行延长手术的患者与间隔超过12个月进行延长手术的患者在治疗效果和并发症方面的差异。
在本研究中，我们在59例患者中发现了29例并发症。延长间隔为12个月的组的并发症发生率明显低于间隔超过12个月的组（35.3% 对68%，p<0.05）。此外，间隔12个月的组的患者主弯进展较小，最大后凸角较低，固定节段的身高增加更大（d=7.53±3.69 cm，p<0.05）。相比之下，延长间隔超过12个月的患者更有可能出现矢状面失衡（p<0.05）。
延长间隔超过12个月会有更高的并发症发生率，并增加侧弯进展和脊柱失衡的风险。仅仅为了尽量减少最终融合前的手术次数而增加间隔时间是不明智的。
