Matthew Weintraub, Omar Taha, Ritt Givens, Matan Malka, Mehdi M Elfilali, Kevin Lu, Paul Sponseller, Peter Sturm, Oheneba Boachie-Adjei, John Emans, Francisco Sánchez Pérez-Grueso, Michael G Vitale, Benjamin D Roye
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引用次数: 0
Abstract
Purpose: To quantify the risk of rod fracture after growth-friendly early-onset scoliosis (EOS) surgery, compare the risk of fracture between magnetically controlled growing rods (MCGR) and traditional growing rods (TGR), and compare the risk of fracture based on rod diameter.
Methods: EOS patients undergoing TGR or MCGR instrumentation were identified from a large, multi-national registry (Pediatric Spine Study Group). Subgroup analyses (chi-squared and Mann-Whitney U tests) were performed between rods with diameters ≤ 5 mm and > 5 mm and between MCGR and TGR. To account for difference in follow-up, a log-rank survival analysis was performed between subgroups over a 5-year period.
Results: A total of 1588 patients, representing 3176 rods, met the inclusion criteria. There was no difference in pre-operative Cobb angle or maximum kyphosis between MCGR and TGR groups. At index surgery, MCGR patients were slightly older, taller, and heavier, although BMI was similar. The overall 2-year risk of rod fracture was 3.05%. TGR 2-year fracture risk was higher than MCGR (4.96% vs. 1.82%, p < 0.001). Similarly, among MCGRs, rods with a diameter ≤ 5 mm fractured at a higher rate than those > 5 mm. The 5-year survival analysis corroborated our 2-year findings.
Conclusion: Although relatively rare, the risk of rod fracture in EOS patients may be higher than previously reported. The overall risk of rod fracture is higher with TGR compared to MCGR, and while smaller rod diameter led to increased risk of fracture in MCGR constructs, the rod diameter was not associated with fracture risk in TGR.
目的：量化生长友好型早发型脊柱侧凸（EOS）手术后棒体骨折的风险，比较磁控生长棒（MCGR）与传统生长棒（TGR）的骨折风险，并比较基于棒体直径的骨折风险。方法：接受TGR或MCGR内固定的EOS患者来自一个大型的多国注册中心（小儿脊柱研究组）。亚组分析（卡方检验和Mann-Whitney U检验）在直径≤5mm和直径≤5mm的棒材之间以及MCGR和TGR之间进行。为了解释随访的差异，在5年期间对亚组进行了对数秩生存分析。结果：共有1588例患者（3176例）符合纳入标准。MCGR组和TGR组术前Cobb角和最大后凸无差异。在指数手术中，MCGR患者年龄稍大，身高更高，体重更重，尽管BMI相似。2年竿骨折的总风险为3.05%。TGR组2年骨折风险高于MCGR组（4.96% vs. 1.82%, p 5 mm）。5年生存分析证实了我们2年的发现。结论：虽然相对罕见，但EOS患者竿骨折的风险可能高于先前报道。与MCGR相比，TGR的杆断裂的总体风险更高，而较小的杆直径导致MCGR结构的骨折风险增加，但在TGR中，杆直径与骨折风险无关。证据等级：四级。
期刊介绍：
Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.
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