Takaso M, Moriya H, Kitahara H, Minami S, Takahashi K, Isobe K, Yamagata M, Otsuka Y, Nakata Y, Inoue M
Department of Orthopaedic Surgery, School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
J Orthop Sci. 1998;3(6):336-40. doi: 10.1007/s007760050062.
Progressive scoliosis in young children has been treated with "spinal instrumentation without fusion" to avoid interference with spinal growth. Patients have to undergo a series of operations to have instruments exchanged for maintaining the correction. We have developed a newly designed remote-controlled growing-rod spinal instrumentation system proposed for the treatment of progressive scoliosis in young children. It can be used to stretch and correct the spinal deformities repeatedly and non-surgically, by means of a remote controller, after the first instrumentation operation. The purpose of this study is to describe the possible clinical application of this system for the treatment of progressive scoliosis in young children. To this end, we used the system in five beagle dogs with induced scoliotic deformities. The maximum distraction force of the instrument was 194 N. Correction of 1 cm was performed non-surgically in awake animals 3 weeks after the instrumentation operation, and then correction of 1 cm was carried out again 6, 9, and 12 weeks after the operation. The average initial Cobb's angle of the induced scoliotic deformities was 25 degrees; this was corrected to 20 degrees, 15 degrees, 8 degrees, and 3 degrees, after the distractions at 3, 6, 9, and 12 weeks, respectively, postoperatively. All corrections were performed non-surgically without apparent complications. By repetitive distractions with the use of our new system, we may be able to reduce the number of operations required in young scoliotic children.
幼儿的进展性脊柱侧弯一直采用“无融合脊柱内固定术”进行治疗，以避免干扰脊柱生长。患者必须接受一系列手术来更换器械以维持矫正效果。我们研发了一种新设计的遥控生长棒脊柱内固定系统，用于治疗幼儿的进展性脊柱侧弯。在首次内固定手术后，借助遥控器，它可用于反复非手术地拉伸和矫正脊柱畸形。本研究的目的是描述该系统在治疗幼儿进展性脊柱侧弯方面可能的临床应用。为此，我们在五只诱导出脊柱侧弯畸形的比格犬身上使用了该系统。器械的最大牵张力为194 N。在器械植入手术后3周，对清醒动物进行非手术矫正1 cm，然后在术后6周、9周和12周再次进行1 cm的矫正。诱导出的脊柱侧弯畸形的平均初始Cobb角为25度；术后分别在3周、6周、9周和12周进行牵张后，该角度分别矫正至20度、15度、8度和3度。所有矫正均通过非手术方式进行，且无明显并发症。通过使用我们的新系统进行反复牵张，我们或许能够减少幼儿脊柱侧弯患者所需的手术次数。
