生长棒技术治疗早发性脊柱侧凸的并发症及其危险因素  

Complications and risk factors of growing rod surgery for early onset scoliosis

作　　者：王孝宾[1] 王冰[1] 吕国华[1] 李晶[1] 卢畅[1] 康意军[1] 

机构地区：[1]中南大学湘雅二医院脊柱外科,长沙410011

出　　处：《中国骨与关节杂志》2017年第1期15-19,共5页Chinese Journal of Bone and Joint

摘　　要：目的探讨生长棒技术治疗早发性脊柱侧凸的并发症及其危险因素。方法回顾性分析2008年1月至2014年6月,我院应用生长棒技术治疗的33例早发性脊柱侧凸患者,其中男18例,女15例。初次手术时的年龄为5~9岁,平均(6.4±2.8)岁。统计围手术期和随访期间各类并发症的发生情况及发生率,将有并发症和无并发症的患者进行分组比较,分析并发症发生的危险因素。结果本组随访24~78个月,平均37.2个月。首次生长棒手术使脊柱获得平均(4.3±2.0)cm生长,后续撑开过程中脊柱每年获得平均(1.1±0.7)cm生长。19例发生了26个并发症,患者的并发症发生率为57.6%,平均每例发生1.4个并发症。共有156次手术操作,单次手术的并发症发生率为16.7%。Logistic回归分析显示,使用单棒、皮下置棒和撑开次数(≥6次)是发生并发症的危险因素。结论生长棒技术治疗早发性脊柱侧凸能够在矫正畸形的同时维持脊柱的生长,但是治疗周期长,并发症发生率高。使用单棒、皮下置棒和撑开次数(≥6次)是发生并发症的危险因素。Objective To investigate postoperative complications and risk factors in early onset scoliosis treated by growing rod. Methods A total of 33 patients with early onset scoliosis who underwent growing rod surgery from January 2008 to June 2014 were identified and enrolled in this study, including 18 males and 15 females. Their average age at initial surgery was（ 6.4 ± 2.8） years old（ range： 5- 9 years old）. Complications occurred during the perioperative period or follow-up were classified and analyzed. Patients＇ preoperative variables were compared between non-complication group and complication group, and risk factors for growing rod complications were finally identified. Results The average follow-up was 37.2 months（ range： 24- 78 months）. T1- S1 length increased（ 4.3 ± 2.0） cm with the initial surgery, and achieved（ 1.1 ± 0.7） cm annual growth with the lengthening procedure. Twenty-six complications occurred in 19 patients. The mean number of complications in each patient was 1.4, and the complication rate per patient was 57.6%. There were 156 procedures, with 16.7% complication rate per procedure. Logistic regression analysis identified the following significant risk factors： single rod, subcutaneous rod placement, and ≥6 rod lengthening procedures. Conclusions Growing rod technique for early onset scoliosis can prevent deformity progression and allow spine and chest growth. However, this treatment needs multiple periodic procedures with a high rate of complications. Single rod, subcutaneous rod placement, and ≥6 rod lengthening procedures are positively associated with risk of complications.

关 键 词：脊柱侧凸 手术后并发症 内固定器 危险因素 

分 类 号：R726.8[医药卫生—儿科]