Clinical Effect Of Dual Growing Rod Technique In The Treatment Of Early Onset Scoliosis

ObjectiveTo analyze the clinical effects of traditional dual growing rods(TDGR)in the treatment of early onset scoliosis(EOS),and to evaluate the clinical efficacy and safety of TDGR.MethodsA total of patients with various types of scoliosis who received posterior spinal internal fixation in our hospital from March 2015 to August 2021 were selected.Excluding missing data or incomplete records and previous history of spinal surgery,20 EOS patients with onset age less than 10 years and treated with dual growing rod technology were selected.The radiographic parameters of the full length of the patient’s spine in the anteropositive and lateral positions and in the left and right Bengding positions before and after the first operation and the last follow-up were collected.The main coronal plane Cobb Angle,thoracic kyphosis Angle,lumbar lordosis Angle,coronal plane balance C7PL-CSVL(CM),sagittal plane balance,parietal deviation,T1-S1 height,fixed segment height,spinal flexibility,coronal plane Cobb Angle of the main coronal plane after the last postoperative follow-up or final surgery,The age of primary surgery,the interval of distraction,the age of terminal fusion,the upper and lower fixation segments,whether the upper and lower fixation was prolonged during the terminal operation and the corresponding complications were recorded.The changes of spinal imaging parameters before,after and during the last follow-up were compared and analyzed,the orthopedic effect of bilateral growth rod technique and its impact on spinal growth were evaluated,and the incidence of complications and possible related factors were counted.ResultsA total of 20 patients were included in this study.The mean preoperative age was(9.03±1.38)years,the mean follow-up time was(28.07±14.3)months,the mean operation time was(256±63.49)min,the hospital stay was(20.56±8.28)days,and the intraoperative blood loss was(288±142.93)ml.The mean value of spinal flexibility was(30.5±12.6)°,and the mean operation dilation was 1.76 times per person.Before the primary operation,the mean Cobb Angle of the main curve was(59.0±16.8)°,t1-S1 height was(31.76±4.42)cm,T1-T12 height was(17.38±2.67)cm,sagittal plane balance was(1.94±0.80)cm,coronal plane balance was(1.52±0.73)cm,thoracic kyphosis Angle was(41.39±5.06)°,lumbar lordosis Angle(45.90±8.04 °),parietal deviation(4.33±1.85)cm;After primary operation,the average Cobb Angle of the main bend was(33.4±11.8)°,T1-S1 height was(34.64±3.96)cm,T1-T12 height was(19.39±2.86)cm,fixed segment height was(22.24±4.73)cm,sagittal plane balance was(1.42±0.56)cm,coronal plane balance was(0.87±0.38)cm,thoracic kyphosis Angle(31.7±3.6)°,lumbar lordosis Angle(42.6±9.1)°,parietal deviation(2.16±1.47)cm;At the last follow-up,the mean Cobb Angle of the main bend was(29.34±11.33)°,T1-S1 height was(37.28±4.36)cm,T1-T12 height was(21.91±2.74)cm,fixed segment height was(24.04±4.98)cm,sagittal balance was(1.26±0.57)cm,coronal balance was(0.77±0.37)cm,thoracic kyphosis Angle(30.24±4.27)°,lumbar lordosis Angle(41.53±8.21)°,parietal deviation(1.61±1.23)cm;T1-s1 growth rate(1.48±0.59)cm/ year,fixed segment growth rate(1.16±0.45)cm/ year,the operation was carried out smoothly,no serious complications.The Cobb Angle of the main coronal curve,thoracic kyphosis Angle,T1-S1 height,T1-T12 height,fixed segment height,parietal deviation and coronal balance were improved immediately after the first operation,and the differences were statistically significant(P < 0.01),and further improved at the last follow-up(P <0.01).ConclusionsDual growing rod technique is a safe and effective method for the treatment of early-onset scoliosis,which can achieve satisfactory orthopaedic results and preserve the longitudinal growth potential of the spine.