新型自动延长生长棒治疗幼猪脊柱侧凸模型的初步研究  

Evaluation of a novel self-lengthening growing rod for early-onset scoliosis in a piglet model

作　　者：孙恒 焦洋[1] 孙佩宇 黄奕臻 赵俊铎 戴家峰 屈伯伦 沈建雄[1] SUN Heng;JIAO Yang;SUN Peiyu;HUANG Yizhen;ZHAO Junduo;DAI Jiafeng;QU Bolun;SHEN Jianxiong(Department of Orthopaedics,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院骨科,北京100730

出　　处：《中华骨与关节外科杂志》2024年第9期844-850,共7页Chinese Journal of Bone and Joint Surgery

基　　金：国家自然科学基金(81974354,82230083);北京市科技计划项目(Z201100005420034)。

摘　　要：目的:评估新型自动延长生长棒治疗幼猪脊柱侧凸模型的有效性。方法:选择12头8周龄雄性约克夏幼猪,通过胸椎(T6~7)和腰椎(L2~3)椎弓根螺钉植入、单棒固定建立脊柱侧凸模型。术后4周造模成功后,12头幼猪随机均分为传统生长棒组和新型生长棒组,每组各6头,分别植入传统生长棒和新型自动延长生长棒。传统生长棒组每2周进行1次撑开手术,共8周。新型生长棒组不进行生长棒撑开手术。所有幼猪在生长棒植入前、植入后即刻和植入后8周拍摄脊柱全长正侧位X线片,测量冠状面主弯Cobb角,同时于生长棒植入后8周测量生长棒延长长度及固定节段脊柱生长长度。结果:造模术后4周,所有幼猪脊柱全长正位X线片测量冠状面主弯Cobb角均>10°,均造模成功。传统生长棒组2头幼猪因首次撑开手术后1周出现深部伤口感染,内固定物松动,予以剔除。其余动物未见感染并发症及神经并发症发生。生长棒植入后8周,传统生长棒组冠状面主弯Cobb角由植入前的14.0°(11.5°,15.8°)改善至3.0°(1.5°,3.8°),新型生长棒组Cobb角由植入前的14.0°(12.5°,14.5°)改善至3.5°(2.5°,4.0°),矫形效果明显。生长棒植入后8周,两组生长棒延长长度及固定节段脊柱生长长度差异均无统计学意义(P均>0.05)。结论:新型自动延长生长棒治疗幼猪脊柱侧凸模型,既能实现脊柱侧凸的良好矫形,又可以促进脊柱生长发育,且无需反复的撑开手术。Objectives:To evaluate the effectiveness of a novel self-lengthening growing rod in the treatment of scoliosis in a piglet model.Methods:Twelve 8-week-old male Yorkshire piglets were selected.Early-onset scoliosis models were established by implanting pedicle screws in the thoracic spine(T6-7)and lumbar spine(L2-3)and fixing with a single rod.Four weeks after successful modeling,the 12 piglets were randomly divided into a traditional growing rod group and a novel self-lengthening growing rod group,with six piglets in each group.The traditional growing rod group underwent lengthening surgery every two weeks for a total of eight weeks,whereas the novel growing rod group did not undergo any lengthening surgery.Anterolateral X-rays of the full-length spine were taken before,immediately after,and 8 weeks after rod implantation to measure the Cobb angle of the main coronal curve.Eight weeks after implantation,the extension length of the rods and the spinal growth length of the fixed segment were also measured.Results:Four weeks after modeling,the Cobb angle of the main coronal curve measured on the anterior-posterior X-rays was>10°in all piglets,indicating successful modeling.Two piglets in the traditional growing rod group were excluded due to deep wound infection and internal fixation loosening one week after the first lengthening surgery.No other animals experience infections or neurological complications.At 8 weeks post-implantation,the Cobb angle of the main coronal curve in the traditional growing rod group improved from 14.0°(11.5°,15.8°)pre-implantation to 3.0°(1.5°,3.8°),and in the novel growing rod group from 14.0°(12.5°,14.5°)to 3.5°(2.5°,4.0°),showing a significant corrective effect.There was no statistically significant difference in the sliding distance of the rods and the spinal growth length of the fixed segment between the two groups(both P>0.05).Conclusions:The novel self-lengthening growing rod can achieve effective scoliosis correction and promote spinal growth without the need for repe

关 键 词：脊柱侧凸 生长棒 幼猪 

分 类 号：R682[医药卫生—骨科学]