在修改生长棒结构后,发生近端结点位的风险
Chidebelum Nnake1, Ritt Givens2, Matthew Weintraub2
1Department of Pediatric Orth opaedic Surgery, Morgan Stanley Children's Hospital of New York Presbyterian, Columbia University Medical Center, 3959 Broadway, CHONY 8N, New York, NY, 10032-3784, USA. con2110@cumc.columbia.edu.
Spine deformity
|June 27, 2025
概括
在早期发病的脊椎 (EOS) 患者中,从肋骨为基础的到脊椎为基础的的修订可能会增加近接节 (PJK) 风险. 虽然在统计学上没有显著意义,但在基于脊柱的改中这种40%的风险增加值得对生长棒程序进行临床考虑.
科学领域:
- 整形外科 整形外科 整形外科
- 儿科脊柱手术 儿科脊柱手术
- 脊椎病研究 脊椎病研究
背景情况:
- 在早期发病的脊椎形 (EOS) 中,后部分心会导致近端结节形 (PJK).
- 基于肋骨的近位固定被假设与基于脊柱的杆相比,可以降低PJK风险.
- 从肋骨到脊柱上修改近端植入物对PJK的影响仍未得到充分研究.
研究的目的:
- 为了研究EOS患者在修复手术后PJK的风险.
- 为了比较PJK发生率的患者修改到肋骨基 (RTR) 和脊椎基 (RTS) 靠近.
- 评估上仪器脊椎 (UIV) 修订水平对PJK发育的影响.
主要方法:
- 对EOS患者进行了回顾性队列研究,这些患者具有基于肋骨的生长结构,正在接受修复手术.
- 最少2年后续检查,包括检查前,检查后和2年后续检查照的评估.
- 排除缺乏横向放射和附着数据的患者;进行了描述性分析.
主要成果:
- 在280名EOS患者中,32%的患者在修订后2年内发展出PJK.
- 转换为基于脊柱的 (RTS) 的患者与基于肋骨的 (RTR) (30.2%) 相比,PJK风险 (42.8%) 较高.
- 转换为基于脊柱的是PJK最强的预测因素 (OR 2.23,p=0.04). 修订级别没有显著影响PJK风险.
结论:
- 与RTR患者相比,RTS患者的PJK风险增加了40%,尽管没有达到统计学意义 (p=0.17),但被认为具有临床意义.
- 修订水平没有显示PJK风险的显著差异.
- 研究结果表明,对脊柱近位的修改可能会增加EOS患者的PJK风险,指导未来用于生长杆结构的手术决策.
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