Brown John-David, Hurry Jennifer, Ouellet Jean, El-Hawary Ron
Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
Department of Diagnostic Radiology, Dalhousie University, Halifax, NS, Canada.
Spine Deform. 2025 Oct 5. doi: 10.1007/s43390-025-01191-z.
To present a case where the novel Modern Luque Trolley (MLT) technique was used to manage a patient with early onset scoliosis (EOS) and to assess the outcomes including graduation to fusion.
Case report.
A 5-year-old female with EOS associated with Prader-Willi syndrome underwent T5-L4 MLT surgery in April 2015. The operation, post-operative course, and 9-year follow-up period were uncomplicated. No autofusion occurred throughout the 7-year growth phase. In April 2022, the patient underwent elective uncomplicated "graduation" surgery to remove the MLT and posterior T5-L4 instrumented fusion was performed. Thirty-one months post-graduation, no complications occurred. During the 7-year growth phase, pre-index, immediate post-index, and 7-year post-index radiographs were analyzed. Scoliosis decreased from 52° to 10° post-index and then increased at 7 years to 31°. Maximal kyphosis increased from 24° to 27° post-index to 43 at 7 years. T1-T12 coronal height increased from 16.0 cm post-index to 20.7 cm at 7 years. T1-S1 coronal height increased from 25.9 cm post-index to 33.9 cm at 7 years. T1-T12 sagittal spine length (SSL) was 15.6 cm post-index and then increased to 20.4 cm at 7 years. T1-S1 SSL increased from 27.2 cm post-index to 35.8 cm 7 years. T1-T12 3D true spine length (3D-TSL) increased from 16.2 cm post-index to 21.5 cm 7 years and T1-S1 3D-TSL increased from 27.3 cm post-index to 36.4 cm 7 years.
These findings demonstrate the potential of MLT to decrease spine deformity and permit spinal growth while reducing autofusion.
介绍一例采用新型现代鲁克推车（MLT）技术治疗早发性脊柱侧弯（EOS）患者的病例，并评估包括过渡到融合手术在内的治疗效果。
病例报告。
一名5岁患有与普拉德-威利综合征相关的EOS女性患者于2015年4月接受了T5-L4 MLT手术。手术、术后过程及9年随访期均无并发症。在7年的生长阶段未发生自发融合。2022年4月，患者接受了择期且无并发症的“过渡”手术以取出MLT，并进行了后路T5-L4器械融合术。过渡后31个月，未出现并发症。在7年生长阶段，分析了术前、术后即刻及术后7年的X线片。脊柱侧弯角度从术前的52°降至术后的10°，然后在7年时增加到31°。最大后凸从术后即刻的24°增加到27°，7年时增加到43°。T1-T12冠状面高度从术后的16.0 cm增加到7年时的20.7 cm。T1-S1冠状面高度从术后的25.9 cm增加到7年时的33.9 cm。T1-T12矢状面脊柱长度（SSL）术后为15.6 cm，7年时增加到20.4 cm。T1-S1 SSL从术后的27.2 cm增加到7年时的35.8 cm。T1-T12三维真实脊柱长度（3D-TSL）从术后的16.2 cm增加到7年时的21.5 cm，T1-S1 3D-TSL从术后的27.3 cm增加到7年时的36.4 cm。
这些发现表明MLT在减少脊柱畸形、允许脊柱生长同时减少自发融合方面具有潜力。
