体表成形术对先天性脊柱侧凸患者生长调节的效果:一项系统综述

IF 1.3 Q3 PEDIATRICS
E. Keykhosravi, H. Rezaee, Amin Tavallaii, Mohammad Abouei Mehrizi, A. Pourbagher-Shahri, Vahid Khajereza Shahri, Ahmad Abdul Sater Abdul Sater
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引用次数: 0

摘要

目的:先天性脊柱侧凸(CS)是脊柱外科的一个难题。凸生长抑制(CGA)是一种治疗方法,旨在抑制曲线的凸生长,而保留的凹生长随着时间的推移纠正脊柱侧凸曲线。鉴于目前临床研究中对CS患者CGA有效性的争议,我们对文献进行了系统的回顾,以澄清争论。方法:在以下数据库和搜索引擎中进行全面的文献检索,以确定评估CS患者CGA结局的研究:Ovid MEDLINE, PubMed, Scopus, Cochrane Central Register of Controlled Trials (CCTR), EMBASE,谷歌Scholar和Web of Science。两位作者对检索结果进行筛选,并在资深作者的指导下选择研究。结果:19项研究,纳入363例患者,手术年龄为58.76个月,4 ~ 216个月不等。前后半表皮成形术是最常见的入路。8项研究在CGA中添加了仪器。平均随访64.57个月。9项研究报告了真正的表皮病变效果(术后和最终随访CCA差异):162例患者中,69例改善,59例稳定,34例进展。其他研究报告了术前和最终随访的CCA差异:88例患者中,49例改善,32例稳定,7例进展。术前曲线大小、矢状面畸形、年龄<5岁和脊柱异常类型对CGA结果没有影响。在复杂的脊柱异常和老年人中首选内固定。结论:CGA单独或联合内固定是可行的CS治疗方法,但选择合适的标准需要重新考虑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Efficiency of Epiphysiodesis for Growth Modulation in Patients with Congenital Scoliosis: A Systematic Review
Purpose: Congenital scoliosis (CS) is a challenging entity in spinal surgery. Convex growth arrest (CGA) is a therapeutic method aiming at inhibiting growth on the curve convexity while remained growth of concavity corrects the scoliotic curve over time. In the view of controversies in current clinical studies for efficiency of CGA in CS patients, we performed a systematic review of the literature to clarify the debate. Methods: A comprehensive literature search was performed to identify studies assessing CGA outcome in CS patients, in following databases and search engines: Ovid MEDLINE, PubMed, Scopus, Cochrane Central Register of Controlled Trials (CCTR), EMBASE, Google Scholar, and Web of Science. Two authors screened the search results and selected the studies by the supervision of senior authors.Results: In 19 studies, enrolling 363 patients, age at surgery was 58.76 months ranging from 4 to 216 months. Anterior and posterior hemiepiphysiodesis was the most common approach. Eight studies added instrumentation to CGA. Follow-up mean was 64.57 months. Nine studies reported true epiphysiodesis effect (postoperative and final follow-up CCA difference): of 162 patients, 69 improved, 59 stabilized, and 34 progressed. Other studies reported preoperative and final follow-up CCA difference: of 88 patients, 49 improved, 32 stabilized, and 7 progressed. Preoperative curve magnitude, sagittal plane deformities, age <5 years, and type of spinal anomalies did not affect CGA outcome. Instrumentation was preferred in complicated spinal anomalies and older ages.Conclusion: CGA alone or with instrumentation is a feasible CS treatment, however criteria for choosing suitable candidates need reconsideration.
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来源期刊
CiteScore
3.90
自引率
0.00%
发文量
0
审稿时长
4 weeks
期刊介绍: International Journal of Pediatrics is a peer-reviewed, open access journal that publishes original researcharticles, review articles, and clinical studies in all areas of pediatric research. The journal accepts submissions presented as an original article, short communication, case report, review article, systematic review, or letter to the editor.
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