凹侧双棒撑开治疗重度早发性脊柱侧凸的中期疗效

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Abstract Objective To analyze the clinical results and perioperative complications of the dual rod distraction technique in the concave side for severe early onset scoliosis(EOS)by mid-term follow-up.Methods 52 patients undergoing dual rod distraction technique in the concave side for severe EOS in our hospital from June 2007 to December 2013 were retrospectively studied.The pedicle screws provided anchors at the end of the rods.The patients’records were reviewed.The parameters included age at initial surgery and the final follow-up，number and frequency of lengthening and complications.Radiographic evaluation included scoliosis Cobb angle，thoracic kyphosis and length of T₁～S₁.Results According to the average frequency of lengthening，the patients were divided into two groups.There were 32 patients(9 males and 23 females) in Group 1.The average age was (7.4±1.1)years(range，4～10 years) at initial surgery.There was a total of 148 surgeries.The average interval between lengthenings was 12.6(range，4～18)months.The mean follow-up was 60.7 (range，30～102)months.Cobb angle decreased from a mean value of (109±23)°preoperatively to (55±16)°after the primary implantation，at final follow-up，the mean Cobb angle was (46±12)°.The average increase of T₁～S₁ length was 1.9 cm per year.There were 20 patients(6 males and 14 females) in Group 2.The average age was (7.7±1.3)years (range，5～10 years) at initial surgery.There was a total of 54surgeries，The average interval between lengthenings was 26.4(range，12～72) months.The mean follow-up was 61.5(range，29～108)months.Cobb angle decreased from a mean value of (104±19)°preoperatively to (51±13)°after the primary implantation，at final follow-up，the mean Cobb angle was (62±17)°.The average T₁～S₁ length was 1.19 cm per year.At final follow-up，the correction of Cobb angle，thoracic kyphosis and trunk shift was better in Group 1 than in Group 2(P＜0.05).As to the T₁～S₁length，there was no significant difference between the two Groups at final follow-up (P＞0.05).There were 9 complications occurred in 7 patients(21.9％)in Group 1 and 15 complications occurred in 12 patients(60％)in Group 2.Conclusion For patients with severe EOS，dual rod distraction technique in the concave side was an effective treatment option.Shortening the interval of lengthening，it can decrease the complications rate and gain better deformity correction while allowing spinal growth.

Key words： early onset scoliosis non-fusion technique complication

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