椎体系留的生长调节反应主要取决于椎体凹陷生长的幅度。

IF 1.6 Q3 CLINICAL NEUROLOGY
Spine deformity Pub Date : 2024-11-01 Epub Date: 2024-06-04 DOI:10.1007/s43390-024-00909-9
Craig R Louer, Vidyadhar V Upasani, Jennifer K Hurry, Hui Nian, Christine L Farnsworth, Peter O Newton, Stefan Parent, Ron El-Hawary
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引用次数: 0

摘要

目的:椎体拴系(VBT)的临床结果存在差异,部分原因是对生长调节(GM)反应的了解有限。我们使用了最大的三维脊柱重建患者样本,以描述椎体和椎间盘在 VBT 术后头两年内伴随生长调节的形态变化:方法:我们利用一个多中心登记册来确定接受过 VBT 并随访两年的特发性脊柱侧凸患者。在纵向时间点获得的校准双平面 X 光片经过三维重建,以获得精确的形态测量结果。GM定义为术后至2年期间器械冠状角的变化:对 50 名患者(平均年龄:12.5 ± 1.3 岁)进行了分析,平均时间为 27.7 个月。GM与凹椎体高度增长呈正相关(r = 0.57,p 10°),在研究期间,凹椎体的平均增长速度比调制不良者(GM)增加了1.6毫米(229%):如果成功,VBT 可使椎体不对称生长,导致术后持续的冠状角矫正(GM)。椎体成角矫正反应强与凹椎体高度增长和整体器械脊柱增长相关。GM反应差则与凸椎间盘高度增加(怀疑系带断裂)有关。未来的研究将调查影响生长重塑增加的患者和特定技术因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Growth modulation response in vertebral body tethering depends primarily on magnitude of concave vertebral body growth.

Purpose: There is variability in clinical outcomes with vertebral body tethering (VBT) partly due to a limited understanding of the growth modulation (GM) response. We used the largest sample of patients with 3D spine reconstructions to characterize the vertebra and disc morphologic changes that accompany growth modulation during the first two years following VBT.

Methods: A multicenter registry was used to identify idiopathic scoliosis patients who underwent VBT with 2 years of follow-up. Calibrated biplanar X-rays obtained at longitudinal timepoints underwent 3D reconstruction to obtain precision morphological measurements. GM was defined as change in instrumented coronal angulation from post-op to 2-years.

Results: Fifty patients (mean age: 12.5 ± 1.3yrs) were analyzed over a mean of 27.7 months. GM was positively correlated with concave vertebra height growth (r = 0.57, p < 0.001), 3D spine length growth (r = 0.36, p = 0.008), and decreased convex disc height (r = - 0.42, p = 0.002). High modulators (patients experiencing GM > 10°) experienced an additional 1.6 mm (229% increase) of mean concave vertebra growth during study period compared to the Poor Modulators (GM < - 10°) group, (2.3 vs. 0.7 mm, p = 0.039), while convex vertebra height growth was similar (1.3 vs. 1.4 mm, p = 0.91).

Conclusion: When successful, VBT enables asymmetric vertebra body growth, leading to continued postoperative coronal angulation correction (GM). A strong GM response is correlated with concave vertebral body height growth and overall instrumented spine growth. A poor GM response is associated with an increase in convex disc height (suspected tether rupture). Future studies will investigate the patient and technique-specific factors that influence increased growth remodeling.

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来源期刊
CiteScore
3.20
自引率
18.80%
发文量
167
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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