传统生长棒技术治疗Ⅰ型神经纤维瘤病营养不良性脊柱侧凸的临床疗效分析OA北大核心

Objective To explore the clinical efficacies and related complications of bilateral traditional growing rods(TGRs)for neurofibromatosis type 1(NF1)dystrophic scoliosis.Methods From March 2016 to July 2021,the clinical data were retrospectively reviewed for 31 children with NF1 dystrophic scoliosis.All chil-dren were treated with TGRs and underwent re-expansion regularly.Cobb angle,T1-T12 height(TTH),T1-S1 height(TSH),trunk shift(TS),local kyphosis(LK)and sagittal vertebral axis(SVA)were measured before,after operation and at the last follow-up.Results There were 17 boys and 14 girls with an average age of initial operation 6.8 years.Immediately post-operation,Cobb angle was compared with that pre-operation[(35.1±16.6)°vs.(68.0±24.1)°,P＜0.05],TTH[(19.7±2.2)cm vs.(16.1±2.6)cm,P＜0.05)],TSH[(32.3±3.0)cm vs.(27.5±3.4)cm,P＜0.05)]and LK[(31.4±8.4)° vs.(46.3±18.1)°,P＜0.05)].Both TS[(10.4±6.8)mm vs.(20.8±15.0)mm,t=4.057,P＜0.05)]and SVA[(17.3±10.9)mm vs.(35.9±26.8)mm,t=3.971,P＜0.05)]significantly improved compared with those pre-operation(P＜0.05).Follow-up period was(2-7)years.At the last follow-up,Cobb angle was(26.8±13.3)°,TTH(22.1±2.8)cm and TSH(36.1±4.0)cm.All differences were statistically significant(P＜0.05).During follow-ups,there were screw displacement(n=4),growing rod fracture(n=3)and distal adding-on phenomenon(n=1).The incidence of complications was 26％.Conclusions TGRs technique is both safe and effective for children with NF1 dystrophic scoliosis.It may ef-fectively control the progress of spinal deformities while preserving the growth capability of spine and thorax.