摘要
目的探讨双侧生长棒技术(dual growing rods,DGR)治疗早发性脊柱侧凸(early onset scoliosis,EOS)的临床疗效及其安全性。方法回顾性分析2015年3月至2021年8月采用DGR治疗EOS患者共20例,男8例,女12例;初次手术时年龄为(9.0±1.4)岁(范围6.3~10.8岁);术前侧凸Cobb角为59.0°±16.8°(范围41.2°~103°)。主要观察指标为侧凸Cobb角、胸椎后凸角、腰椎前凸角、T1~T12高度、T1~S1高度、冠状面平衡、矢状面平衡、顶椎偏距(apical vertebral translation,AVT)及坎贝尔空间供肺比(Campbells space available for lung ratio,SAL),记录手术相关并发症。结果20例患者随访时间(28.07±14.30)个月。初次住院时间为(20.56±8.28)d,初次手术时间为(211.70±39.80)min,初次手术出血量为(255.00±149.50)ml,手术撑开为(1.60±0.51)次/例。主弯Cobb角自术前59.00°±16.80°降至初次术后的33.40°±11.80°,术后1年为29.67°±11.67°,末次随访时为29.40°±11.30°;术前胸椎后凸角为41.39°±6.06°,初次术后减少至31.72°±3.56°,术后1年为30.32°±4.26°,末次随访时为30.24°±4.23°;术前腰椎前凸角为45.90°±8.03°,初次术后减少至42.65°±9.05°,术后1年为41.55°±7.84°,末次随访时为41.53°±8.21°;术前T1~S1高度为(31.76±4.42)cm,初次术后增加至(34.64±3.96)cm,术后1年为(36.73±3.87)cm,末次随访时为(37.28±4.36)cm;术前T1~T12高度为(17.38±2.76)cm,初次术后增加至(19.39±2.86)cm,术后1年为(21.77±2.71)cm,末次随访时为(21.91±2.74)cm;术前冠状面平衡为(1.52±0.73)cm,初次术后减少至(0.87±0.38)cm,术后1年为(0.81±0.38)cm,末次随访时为(0.77±0.37)cm;术前矢状面平衡为(1.94±0.78)cm,术后减少至(1.42±0.56)cm,术后1年为(1.28±0.55)cm,末次随访时为(1.26±0.57)cm;术前AVT为(4.33±1.85)cm,初次术后减少至(2.16±1.47)cm,术后1年为(1.63±1.17)cm,末次随访时为(1.61±1.23)cm;SAL自术前0.88±0.05增加至初次术后0.94±0.03,术后1年为0.96±0.01,末次随访时为0.97±0.01;以上
Objective To investigate the clinical efficacy of dual growing rods(DGR)in the treatment of early onset scoliosis(EOS),and to evaluate the safety of its clinical application.Methods From March 2015 to August 2021,a total of 20 EOS patients with onset age within 10 years old who were treated with dual growth rod technique were retrospectively analyzed,including 8 males and 12 females.The mean age of patients at first surgery was 9.0±1.4 years(range,6.3-10.8 years);the preoperative Cobb angle was 59.0°±16.8°(range,41.2°-103°).The Cobb angle,thoracic kyphosis angle,lumbar lordosis angle,T1-T12 height,T1-S1 height,coronal plane imbalance,sagittal vertical axis(SVA),apical vertebral translation(AVT)and Campbell's space available for lung ratio(SAL)were recorded and analyzed while surgery-related complications were also recorded.Results The average follow-up time of 20 patients was 28.07±14.30 months.The average initial hospital stay was 20.56±8.28 days,the average initial operation time was 211.70±39.80 min,the average blood loss in the initial operation was 255.00±149.50 ml,and the average surgical distraction was 1.60±0.51 times per person.The Cobb angle of the main curve in the coronal plane decreased from 59.00°±16.80°before operation to 33.40°±11.80°after the initial operation,which was 29.67°±11.67°at 1 year and 29.40°±11.30°at the last follow-up.Preoperative thoracic kyphosis angle was 41.39°±6.06°,decreased to 31.72°±3.56°after the initial operation,was 30.32°±4.26°at 1-year and 30.24°±4.23°at the last follow-up;preoperative lumbar lordosis angle was 45.90°±8.03°,decreased to 42.65°±9.05°after initial operation,41.55°±7.84°at 1-year follow-up,and 41.53°±8.21°at the last follow-up;preoperative T1-S1 height was 31.76±4.42 cm,initial after operation,it increased to 34.64±3.96 cm,36.73±3.87 cm at 1 year,and 37.28±4.36 cm at the last follow-up;preoperative T1-T12 height was 17.38±2.76 cm.increased to 19.39±2.86 cm after the initial operation,21.77±2.71 cm at 1 y
作者
江仲景
刘敏智
邓盎
郭超峰
张宏其
Jiang Zhongjing;Liu Minzhi;Deng Ang;Guo Chaofeng;Zhang Hongqi(Department of Spine Surgery and Orthopaedics,National Clinical Research Center for Geriatric Disorders,Xiangya Hospital,Central South University,Changsha 410008,China)
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2022年第18期1220-1229,共10页
Chinese Journal of Orthopaedics
关键词
脊柱侧凸
脊柱融合术
生长和发育
治疗结果
eScoliosis
Spinal fusion
Growth and development
Treatment outcome
