折断绳索的命运:脊柱体绑定治疗的曲线在绳索断裂后如何表现?
Tyler A Tetreault1, Tiffany N Phan1, Tishya A L Wren1
1Jackie and Gene Autry Children's Orthopedic Center, Children's Hospital Los Angeles, Los Angeles, CA.
Spine
|June 12, 2024
概括
脊椎体绑定 (VBT) 后的绳索断裂是常见的. 骨不成熟的患者的曲线超过35度,最有可能需要修改手术,大多数经历曲线进展.
科学领域:
- 整形外科 整形外科 整形外科
- 脊柱外科手术 脊柱外科手术
- 儿科整形外科 儿科整形外科
背景情况:
- 带断裂是脊椎体带 (VBT) 后的常见并发症,在多达50%的病例中发生.
- 绳索断裂的长期后果,包括曲线进展和修复手术的需要,尚未得到充分证实.
研究的目的:
- 在接受VBT的患者中,评估绳索断裂后曲线进展.
- 为了确定VBT带故障后修复手术的发生率和相关因素.
主要方法:
- 青少年和青少年异常学脊椎病患者的回顾性多中心综述,在VBT后至少进行了2年的随访.
- 连续射线图上发现的>5度螺丝分歧的绳索断裂;记录了修改程序和曲线大小.
主要成果:
- 在186名患者中,有84人 (45.2%) 经历了绳索断裂. 在这些患者中有14.5%的患者进行了修复手术.
- 骨不成熟的患者 (Risser 0-3),在骨折时曲线≥35度,经历修复的可能性明显更高 (53%对13%).
- 曲线在破裂后的第一年和第二年分别平均进展3.1度和3.7度. 50%的人在2年内进展 >5度.
结论:
- 骨不成熟的患者在断时的曲线≥35度,面临需要进一步手术干预的最高风险.
- 在绳索断裂后的头两年,明显的曲线进展是常见的,但长期的结果仍然不确定.
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