术前高体重指数与磁控生长棒治疗早发性脊柱侧凸患者植入物断裂相关

IF 1.5 3区 医学 Q3 ORTHOPEDICS
Journal of Pediatric Orthopaedics Pub Date : 2025-09-01 Epub Date: 2025-05-05 DOI:10.1097/BPO.0000000000002988
Antti J Saarinen, Lindsay Andras, Oheneba Boachie-Adjei, Patrick Cahill, Tenner Guillaume, Brian Snyder, Paul Sponseller, Peter Sturm, Michael Vitale, Ilkka Helenius
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引用次数: 0

摘要

简介:磁控生长棒(MCGRs)已成为目前早发性脊柱侧凸(EOS)患者生长友好型治疗的标准。mcgr允许使用外部延长装置进行无创延长,减少了手术治疗的需要。术前体重指数(BMI)与MCGR治疗结果的关系尚不清楚。方法:对前瞻性收集的国际数据库中接受MCGR治疗的EOS患者进行回顾。结果:663例患者被分为体重过轻组(n=91)、健康体重组(n=417)和超重组(n=155)。无论病因如何,BMI组在主要曲线矫正或胸高增加方面无显著差异。不同病因的BMI分类分布差异有统计学意义(P=0.009),综合征组健康体重比例(92/ 167.55%)低于特发性(131/ 177.74%)(校正P=0.004),神经肌肉组体重不足比例(36/ 244.15%)高于特发性(15/ 177.8.5%)(校正P=0.044)。较高的BMI z评分与并发症发生率增加相关,包括种植体相关并发症(RR 1.1, 95% CI 1.0-1.3)和种植体断裂(RR 1.3, 95% CI 1.1-1.7)。与超重患者相比,健康体重和体重过轻患者的总体并发症发生率较低。与超重患者相比,体重过轻患者的种植体相关并发症较少(RR 0.45, 95% CI 0.20-0.90)。较高的BMI z-score是假体断裂的重要预测因子,而术前主要曲线、后凸和病因则不是。EOSQ-24评分在BMI组间无显著差异,随访期间各组间评分变化具有可比性。结论:早发性脊柱侧凸患者的BMI状态不影响曲线矫正、胸高增加或EOSQ-24结果。然而,超重患者种植体断裂的发生率较高,这表明在计划治疗时应仔细考虑BMI升高。证据等级:三级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

High Preoperative Body Mass Index Is Associated With Implant Breakage in Patients Treated With Magnetically Controlled Growing Rods for Early-onset Scoliosis.

High Preoperative Body Mass Index Is Associated With Implant Breakage in Patients Treated With Magnetically Controlled Growing Rods for Early-onset Scoliosis.

Introduction: Magnetically controlled growing rods (MCGRs) have become the current standard in the growth-friendly treatment of patients with early-onset scoliosis (EOS). MCGRs allow noninvasive lengthenings with external lengthening device and reduce the need for surgical procedures. The association of preoperative body mass index (BMI) and the outcomes of the MCGR treatment is not well known.

Methods: Prospectively collected international database was reviewed for EOS patients treated with MCGR. Patients without preoperative BMI data or follow-up <2 years were excluded. Patients were classified as healthy weight, overweight, and underweight using Centers for Disease Control and Prevention (CDC) growth charts. Quality of life was assessed using EOSQ-24. Results were analyzed from the 2-year follow-up.

Results: A total of 663 patients were categorized into underweight (n=91), healthy weight (n=417), and overweight (n=155) groups. There were no significant differences in major curve correction or thoracic height increase among the BMI groups, irrespective of etiology. Distribution of BMI categories differed significantly by etiology ( P =0.009), with lower healthy weight proportions in the syndromic group (92/167, 55%) compared with idiopathic (131/177, 74%) (adjusted P =0.004), and a higher underweight proportion in neuromuscular (36/244, 15%) compared with idiopathic (15/177, 8.5%) (adjusted P =0.044). Higher BMI z-scores were associated with an increased incidence of complications, including implant-related complications (RR 1.1, 95% CI 1.0-1.3) and implant breakage (RR 1.3, 95% CI 1.1-1.7). Healthy weight and underweight patients experienced lower overall complication rates compared with overweight patients. Implant-related complications were less common in underweight patients compared with overweight patients (RR 0.45, 95% CI 0.20-0.90). Higher BMI z-score was a significant predictor of implant breakage, whereas preoperative major curve, kyphosis, and etiology were not. EOSQ-24 scores did not differ significantly among BMI groups, and changes in scores were comparable across groups during follow-up.

Conclusion: BMI status did not influence curve correction, thoracic height increase, or EOSQ-24 outcomes in early-onset scoliosis patients. However, the higher incidence of implant breakage in overweight patients suggests that elevated BMI should be carefully considered when planning treatment.

Level of evidence: Level III.

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来源期刊
CiteScore
3.30
自引率
17.60%
发文量
512
审稿时长
6 months
期刊介绍: ​Journal of Pediatric Orthopaedics is a leading journal that focuses specifically on traumatic injuries to give you hands-on on coverage of a fast-growing field. You''ll get articles that cover everything from the nature of injury to the effects of new drug therapies; everything from recommendations for more effective surgical approaches to the latest laboratory findings.
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