| ObjectiveTo analyze the clinical effect of sliding growth rods technique as a growth guidance technique in the treatment of early-onset scoliosis,and to explore the feasibility and safety of its clinical application.MethodsFrom January 2013 to September 2017,12 patients(3 males and 9 females)with EOS diagnosed in the Department of Orthopedics of the first affiliated Hospital of Zhengzhou University were followed up for at least 2 years.The general data of the patients and the indexes during perioperative period and follow-up were collected.The X-ray films of the full length of the spine were taken before operation,after operation and during the last follow-up,as well as the left and right Bending images,and the imaging parameters were measured,including coronal main curve Cobb angle,coronal balance,spinal flexibility rate(FR),T1-T12 segment height,T1-S1 segment height and fixed segment height,sagittal kyphosis angle,sagittal vertical axis(SVA).Lumbar lordosis angle(LL),pelvic incidence angle(PI),sacral slope angle(SS),pelvic tilt angle(PT).The statistical method of one-way analysis of variance was used to compare the differences among the indexes before operation,after operation and the last follow-up,and to analyze the changes and significance of each index.ResultsThe average preoperative age of the 12 patients was(6.55±1.67)years,and the average postoperative follow-up time was(34.26±8.72)months.The coronal main curve Cobb angle was significantly corrected from(70.58±8.85)°before operation to(25.87±6.13)°after operation(P<0.05),and the last follow-up was(23.15±4.51)°.There was no significant difference between the two groups of last follow-up and after operation(P=0.229).The coronal balance,sagittal kyphosis angle and SVA were significantly improved after operation(P<0.05).There was no significant difference in LL,PI,SS and PT among the three groups before operation,after operation and the last follow-up(P>0.05).The height of T1-T12 segment increased significantly from(14.18±1.79)cm,before operation to(16.52±1.85)cm,after operation,and at the last follow-up,it was(19.13±2.04)cm,and there was significant difference between different time points(P<0.05).The height of T1-S1 segment increased significantly from(22.97 ±2.14)cm,before operation to(27.53±2.06)cm,after operation,and at the last follow-up,it was(30.78±2.23)cm,there was significant diference between different time points(P<0.05).The height of fixed segment increased significantly from(15.79±1.86)cm,before operation to(19.81±2.14)cm,after operation.The last follow-up was(22,14±2.19)cm,and there was significant difference between different time points(P<0.05).Within 2 years after operation,the total height of T1-T12 segments increased by 1.28cm with an average growth rate of 0.64 cm/years,the height of T1-S1 segments increased by 1.61cm with an average growth rate of 0.81cm/years,and the height of fixed segments increased by 1.37cm with an average growth rate of 0.69cm/years.No serious complications occurred in all the patients,including 2 cases of internal fixation related complications,1 case of postoperative Adding-on phenomenon and 1 case of replacement of internal fixation rod.ConclusionsAs a growth guidance technique,the sliding growth rods technique can not only correct scoliosis deformity and obtain satisfactory orthopedic effect in the clinical treatment of patients with early-onset scoliosis,but also effectively retain the spinal growth potential of the patients at the same time,so that the spinal growth potential can be released continuously and actively during the growth and development of the patients,which can effectively avoid the interval stretching operation and the traditional series of stretching operations.The incidence of operation-related complications was reduced. |
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