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Abstract：
Background: The management of spinal deformities diagnosed before the age of 10 is critical due to the child\'s development, skeletal system, and growth mechanism. Magnetically controlled growing rods (MCGRs) are a surgical treatment option for the growing spine. The aim of this study was to analyze the radiological findings of patients treated with MCGRs for early-onset scoliosis (EOS) of various etiologies. We hypothesized that the MCGRs could provide acceptable long-term radiographic results, such as an increase in the T1-T12 and T1-S1 height and significant overall deformity correction. Methods: We retrospectively reviewed 161 EOS patients with a combined total of 302 MCGRs inserted at five institutions between 2016 and 2022 with a mean follow-up of at least two years. The Cobb angle of the major curve (MC), thoracic kyphosis (TK), lumbar lordosis (LL), and T1-T12 and T1-S1 height measurements were assessed before, after, and during the follow-up. Results: Among the 90 female and 71 male patients, there were 51 neurological, 42 syndromic, 58 idiopathic, and ten congenital scoliosis etiologies. Of the patients, 73 were aged under six years old. The mean follow-up time was 32.8 months. The mean age at placement of the MCGRs was 7 years and that at the last follow-up after fusion surgery was 14.5 years. The mean MC before the initial surgery was 86.2°; following rod implantation, it was 46.9°, and at the last follow-up visit, it was 45.8°. The mean correction rate among the etiology subgroups was from 43% to 50% at follow-up. The mean TK was noted as 47.2° before MCGR implantation, 47.1° after MCGR placement, and 44.5° at the last follow-up visit. The mean T1-T12 height increased by 5.95 mm per year, with a mean T1-S1 height of 10.1 mm per year. Conclusions: MCGR treatment allowed for an average correction of the curvature by 50% during the period of lengthening, while controlling any deformity and growth of the spine, with a significant increase in the T1-T12 and T1-S1 values during the observation period. MCGR treatment in EOS carries a risk of complications. While congenital and syndromic EOS often have short and less flexible curves in those groups of patients, single rods can be as effective and safe. Definitive fusion results in the mean final coronal correction between the start of MCGR treatment and after undergoing PSF of approximately 70%. The mean T1-T12 spinal height increased by 75 mm, while the T1-S1 spinal height gained a mean of 97 mm.
摘要：
背景：由于儿童的发育，10岁前诊断的脊柱畸形的治疗至关重要，骨骼系统，和生长机制。磁控生长棒(MCGR)是生长脊柱的手术治疗选择。这项研究的目的是分析接受MCGRs治疗的各种病因的早发性脊柱侧弯（EOS）患者的放射学发现。我们假设MCGR可以提供可接受的长期射线照相结果，例如T1-T12和T1-S1高度的增加和显着的整体畸形矫正。方法：我们回顾性分析了161例EOS患者，在2016年至2022年期间在五个机构插入了302例MCGR，平均随访至少两年。主曲线的Cobb角(MC),胸椎后凸(TK),腰椎前凸(LL),和T1-T12和T1-S1高度测量之前进行了评估，之后,在后续行动中。结果:90例女性患者和71例男性患者中,有51个神经科，42综合征，58特发性，和十种先天性脊柱侧凸病因。在患者中，73岁以下。平均随访时间为32.8个月。MCGR的平均年龄为7岁，融合手术后的最后一次随访为14.5岁。初次手术前的平均MC为86.2°；棒植入后，它是46.9°，在最后一次随访中，它是45.8°。随访时，病因亚组的平均纠正率为43％至50％。MCGR植入前平均TK为47.2°,MCGR放置后47.1°,和44.5°在最后一次随访。平均T1-T12高度每年增加5.95毫米，平均T1-S1高度为10.1毫米每年。结论：MCGR治疗允许在延长期间将曲率平均校正50％，同时控制脊柱的任何畸形和生长，观察期间T1-T12和T1-S1值显着增加。EOS中的MCGR治疗存在并发症的风险。虽然先天性和综合征性EOS在这些患者组中通常具有短且不太灵活的曲线，单棒可以是有效和安全的。最终融合导致MCGR治疗开始与经历PSF后之间的平均最终冠状校正约为70％。平均T1-T12脊柱高度增加了75毫米，而T1-S1脊柱高度平均增加了97毫米。
