【摘要】：目的:觀察生長(zhǎng)棒治療1型神經(jīng)纖維瘤病早發(fā)性脊柱側(cè)凸的有效性。方法:回顧性分析13例生長(zhǎng)棒治療的1型神經(jīng)纖維瘤病早發(fā)性脊柱側(cè)凸患者的臨床資料,其中男8例,女5例;年齡5~10歲(7.5±2.1歲)。隨訪時(shí)間2~10年(5.1±2.8年)。生長(zhǎng)棒置入術(shù)后每6個(gè)月?lián)伍_(kāi)1次。影像學(xué)測(cè)量指標(biāo)包括側(cè)凸Cobb角、后凸角、軀干高度(T1~S1),并統(tǒng)計(jì)手術(shù)并發(fā)癥。結(jié)果:術(shù)前側(cè)凸Cobb角69.0°±21.2°(43°~90°),末次隨訪25.3°±15.0°(12°~45°),矯正率63.3%。軀干高度術(shù)前323.0±29.1mm(288~355mm),末次隨訪400.5±25.7mm(361~430mm),軀干高度增加77.1±18.3mm,每年繼續(xù)生長(zhǎng)11.7±3.3mm。9例患者出現(xiàn)并發(fā)癥,并發(fā)癥發(fā)生率69.2%。共發(fā)生并發(fā)癥16例次,包括內(nèi)置物失敗9例次(56.3%),交界區(qū)后凸5例次(31.3%),內(nèi)置物外露1例次(6.2%),深部感染1例次(6.2%)。9例后凸角50°患者中6例(66.7%)出現(xiàn)并發(fā)癥,4例后凸角≥50°患者中3例(75%)出現(xiàn)并發(fā)癥,兩組并發(fā)癥發(fā)生率差異無(wú)統(tǒng)計(jì)學(xué)意義(χ~2=0.123,P=0.726)。結(jié)論:生長(zhǎng)棒治療1型神經(jīng)纖維瘤病早發(fā)性脊柱側(cè)凸可有效改善脊柱畸形,并且保持軀干的繼續(xù)生長(zhǎng);伴有嚴(yán)重后凸并未增加術(shù)后并發(fā)癥的發(fā)生率。
[Abstract]:Objective: to observe the efficacy of growth rod in the treatment of type 1 neurofibromatosis with early onset scoliosis. Methods: the clinical data of 13 patients with type 1 neurofibromatosis with early onset scoliosis treated with growth rod were analyzed retrospectively, including 8 males and 5 females, aged 5 鹵10 years (7.5 鹵2.1 years). The follow-up time was 2 to 10 years (5.1 鹵2.8 years). The growth rod was opened every 6 months after implantation. Imaging measurements included scoliosis Cobb angle, kyphosis angle, trunk height (T1~S1), and surgical complications were counted. Results: the Cobb angle of scoliosis was 69.0 擄鹵21.2 擄(43 擄~ 90 擄) and the last follow-up was 25.3 擄鹵15.0 擄(12 擄~ 45 擄). The correction rate was 63.3%. The height of trunk was 323.0 鹵29.1mm (288~355mm) before operation and 400.5 鹵25.7mm (361~430mm) at the last follow-up. The height of trunk increased by 77.1 鹵18.3mm. Complications occurred in 11.7 鹵3.3mm.9 patients. The incidence of complications was 69.2%. Complications occurred in 16 cases, including 9 cases of built-in failure (56.3%), 5 cases of kyphosis in junction area (31.3%), 1 case of internal exposure (6.2%) and 1 case of deep infection (6.2%). Complications occurred in 6 cases (66.7%) of 9 patients with kyphosis angle 50 擄and 3 cases (75%) of 4 patients with kyphosis angle 鈮，

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