新型滑槽钉生长棒内固定系统治疗儿童脊柱侧凸的初步报告

 目的 评价新型滑槽钉生长棒内固定系统在儿童脊柱侧凸治疗中的初步临床疗效。 方法 自2009年1月至2011年7月，使用滑槽钉生长棒内固定系统治疗脊柱侧凸患儿10例，男3例，女7例；年龄4～12岁，平均7.8岁。Risser征均为0级。均为特发性脊柱侧凸。单胸弯3例，单胸腰弯或腰弯6例，双胸弯1例。入院时冠状位Cobb角38°~85°，平均66.8°；矢状位Cobb角38°~66°，平均45.5°；坐高36~64 cm，平均48.6 cm。疗效评价指标包括冠状位、矢状位Cobb角及其矫正率、坐高、躯干偏移、双肩高度差、植骨融合情况、矫正丢失率和并发症，重点在身高和发育情况。结果 术后即刻冠状位Cobb角17°~39°，平均28°，矫正率为48%～65%，平均为52%。术后矢状位Cobb角25°~39°，平均31°，坐高46~70 cm，平均56.8 cm。全部病例随访12～44个月，平均26.5个月。随访期间矫正角度丢失率＜ 5%，坐高平均增加2 cm ，3例出现矫形棒尾端皮肤感染，均予以局部换药后痊愈，1例术后出现肩部失平衡，余未出现断钉、断棒等内固定相关并发症。结论 新型滑槽钉生长棒内固定系统治疗儿童脊柱侧凸的初步临床疗效证实该系统的有效性和安全性。

Preliminary clinical application of the new instrumentation growing rods of sliding pedicle screw system for scoliosis in children

Objective To evaluate the primary clinical outcome of the new instrumentation growing rods of sliding pedicle screw system in the treatment of scoliosis in children. Methods From January 2009 to July 2011, 10 patients with idiopathic scoliosis were treated using a new instrumentation growing rods of sliding pedicle screw system. There were 3 males and 7 females, aged from 4 to 12 years (average, 7.8 years). Risser sign was grade 0 in all patients. There were 3 cases of single thoracic curve, 6 cases of single thoracolumbar or lumbar curve, and 1 case of double thoracic curve. Before operation, the average coronal Cobb angle was 66.8°(range, 38° to 85°) , the average sagittal Cobb angle was 45.5°(range, 38° to 66°), and the average sitting height was 48.6 cm (range, 36 cm to 64 cm). During the follow-up period, some parameters were observed, such as coronal and sagittal Cobb angles, sitting height, complications and so on. Result Immediately after operation, the average coronal Cobb angle was 28°(range, 17°to 39°) with the average correction rate of 56%(range, 48% to 65%), the average sagittal Cobb angle was 31° (range, 25°to 39°), and the average sitting height was 56.8 cm (range, 40 cm to 70 cm). All patients were followed up for 12 to 44 months (average, 26.5 months). At final follow-up, the average sitting height increase by 2 cm, skin infection at the end of the rod occurred in 3 cases, which recovered after local dressing change, and shoulder imbalance occurred in 1 cases. There were no broken screws, broken rods and other internal fixation-related complications. Conclusion The new instrumentation growing rods of sliding pedicle screw system is effective and safe in the treatment of scoliosis in children.