UNASSIGNED: Retrospective search was conducted between 2017 and 2023. Patients with genetically confirmed SMA type 1 who were surgically treated for spinal deformity and receiving DMTs (nusinersen, risdiplam, or onasemnogene abeparvovec) were included. SMA types 2 and 3 and patients who do not receive DMTs were excluded. Clinical and radiographic data were collected at preoperative, postoperative, and latest follow-up visits.
UNASSIGNED: Twenty-eight patients (mean follow-up: 16 months (range 2-41)) were included. The mean age at surgery was 60 months (range 29-96). Fifteen were treated with dual magnetically controlled growing rods (MCGR), four with unilateral MCGR and a contralateral guided growth system, three with Vertical Expandable Prosthetic Titanium Rib (VEPTR®) implants, five with self-distracting systems, and one with traditional dual growing rods. The mean amount of correction was 57% (44°± 17) for scoliosis and 83% (13°± 11) for pelvic obliquity. The mean T1-12 height gain during surgery was 31 mm (±16 mm), while the mean T1 S1 height gain was 51 mm (±24 mm), and instrumented growth was observed during follow-up. Five patients (18%) developed six serious adverse events: three surgical site infections, two anchor failures, and one rod fracture, and all required unplanned reoperations. No neurologic complication, difficulty during nusinersen injections, or respiratory decline was recorded.
UNASSIGNED: We report that spinal deformity in this population can be safely treated with growth-friendly instrumentation, with similar complication rates when compared with SMA type 2.
■在2017年至2023年之间进行了回顾性搜索。经基因证实的1型SMA患者,因脊柱畸形接受手术治疗并接受DMT(nusinersen,risdiplam,或asemnogeneabeparvovec)被包括在内。2型和3型SMA和未接受DMT的患者被排除。术前收集临床和影像学数据,术后,以及最新的后续访问。
■28例患者(平均随访:16个月(范围2-41))被纳入。手术时的平均年龄为60个月(范围29-96)。用双磁控生长棒(MCGR)处理15个,四个具有单侧MCGR和对侧引导生长系统,三个带有垂直可扩展的人造钛肋骨(VEPTR®)植入物,五个有自我分散注意力的系统,还有一个传统的双重生长棒。脊柱侧凸的平均矫正量为57%(44°±17),骨盆倾斜的平均矫正量为83%(13°±11)。手术期间T1-12的平均身高增加为31毫米(±16毫米),而平均T1S1高度增益为51毫米(±24毫米),在随访期间观察到仪器生长。5例患者(18%)发生6例严重不良事件:3例手术部位感染,两个锚故障,一根杆断裂,和所有需要计划外的重新操作。没有神经系统并发症,在nusinersen注射期间有困难,或记录呼吸下降。
■我们报告说,该人群的脊柱畸形可以用生长友好的仪器安全治疗,与SMA2型相比,并发症发生率相似。