Zhu Weiwei,Zhang Xuejun,Cao Jun,et al.Comparison of the Results of Different Number of Proximal Anchor Points on Growing Rod Technique in the Treatment of Early Onset Scoliosis[J].Journal of Clinical Pediatric Surgery,,20():14-18.[doi:10.12260/lcxewkzz.2021.01.003]
Comparison of the Results of Different Number of Proximal Anchor Points on Growing Rod Technique in the Treatment of Early Onset Scoliosis
- Keywords:
- Scoliosis/SU; Scoliosis/TH; Growing Rod Technique; Treatment Outcome
- CLC:
- R726.8;R682.3
- Abstract:
- Objective To compare the surgical outcomes in different number of proximal anchor points on bilateral growing rod technique in the Treatment of early onset scoliosis.Methods All EOS patients treated with bilateral growing rod technique in our hospital from January 2016 to March 2020 were retrospectively reviewed.Patients with complete imaging data of preoperative,postoperative and last follow-up,follow-up time ≥ 2 years,lengthening procedure ≥ 2 times were included in this study.Patients were divided into 2 groups according to the number of anchor points:A group,4 proximal anchor points and 4 distal anchor points,15 cases; B group,6 proximal anchor points and 4 distal anchor points,18 cases.Cobb angle of main curve(MC),T1-S1 height,C7PL-CSVL distance,radiographic shoulder height(RSH),Cobb angle of thoracic kyphosis(TK),sagittal vertical axis (SVA),unplanned surgery,Implant complications were recorded during follow-up.These parameters were analyzed.Results There was no significant difference in preoperative age,number of different genders,follow-up time and lengthening procedures between the two groups (P>0.05).The Cobb angle of MC decreased and the T1-S1 height increased in the last follow-up between the two groups(P<0.05).There was no significant difference in the Cobb angle of TK between preoperative and last follow-up in group A (P>0.05),but Cobb angle of TK decreased compared with preoperative at the last follow-up in group B was significant differences(P<0.05).The change value of MC Cobb angle and TK Cobb angle compared between preoperative and the last follow-up was larger in group B than group A(P<0.05).Conclusion Both 4 proximal anchor points and 6 proximal anchor points can effectively correct the coronal main curve and maintain the growth of the spine.However,larger correction degree of MC and TK were achieved in 6 proximal anchor points group; Meanwhile,anchor-related complications were lower.The use of additional anchor points may be considered for large MC(cobb angle>70°),especially for the patient with larger TK (cobb angle>40°).
References:
1 Cunin V.Early-onset scoliosis: current treatment[J].Orthop Traumatol Surg Res,2015,101(1 Suppl):S109-S118.DOI:10.1016/j.otsr.2014.06.032.
2 Yang S,Andras LM,Redding GJ,et al.Early-Onset Scoliosis: A Review of History,Current Treatment,and Future Directions[J].Pediatrics,2016,137(1):2015-0709.DOI:10.1542/peds.2015-0709.
3 Bess S,Akbarnia BA,Thompson GH,et al.Complications of growing-rod treatment for early-onset scoliosis: analysis of one hundred and forty patients[J].J Bone Joint Surg Am,2010,92(15):2533-2543.DOI:10.2106/JBJS.I.01471.
4 Nikouei F,Ghandhari H,Ameri E,et al.Complications of Fusionless Correction of Early Onset Scoliosis Using Dual Growing Rods[J].Arch Iran Med,2018,21(12):595-599.
5 Helenius IJ,Oksanen HM,McClung A,et al.Outcomes of growing rod surgery for severe compared with moderate early-onset scoliosis: a matched comparative study[J].Bone Joint J,2018,100-B(6):772-779.DOI: 10.1302/0301-620X.100B6.BJJ-2017-1490.R1.
6 Yang S,Andras LM,Redding GJ,et al.Early-Onset Scoliosis: A Review of History,Current Treatment,and Future Directions[J].Pediatrics,2016;137(1):e20150709.DOI:10.1542/peds.2015-0709.
7 Odent T,Ilharreborde B,Miladi L,et al.Fusionless surgery in early-onset scoliosis[J].Orthop Traumatol Surg Res,2015,101(6 ):S281-S288.DOI: 10.1016/j.otsr.2015.07.004.
8 Chen Z,Qiu Y,Zhu Z,et al.How Does Hyperkyphotic Early-Onset Scoliosis Respond to Growing Rod Treatment?[J].J Pediatr Orthop,2017,37(8):e593-e598.DOI:10.1097/BPO.0000000000000905.
9 Li WJ,Sun ZJ,Guo SG,et al.The effect of growing Rod treatment on coronal balance during serial lengthening surgeries in early onset scoliosis[J].BMC Musculoskelet Disord,2016,17:158.DOI:10.1186/s12891-016-1007-x.
10 Pan A,Hai Y,Yang J,et al.Upper Instrumented Vertebrae Distal to T2 Leads to a Higher Incidence of Proximal Junctional Kyphosis During Growing-rod Treatment for Early Onset Scoliosis[J].Clin Spine Surg,2018,31(7):E337-E341.DOI: 10.1097/BSD.0000000000000661.
Memo
收稿日期:2020-06-15。
基金项目:北京市医院管理局"扬帆"计划（编号：XLML201818）
通讯作者:曹隽,Email:caojunhere@yeah.net