Orthopedic mechanism analysis of growing rod distraction for early-onset scoliosis based on 3D morphological parameters.

Autor: Lu D; Beijing Key Laboratory for Design and Evaluation Technology of Advanced Implantable & Interventional Medical Devices, School of Biological Science and Medical Engineering, Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China., Wu X; Beijing Key Laboratory for Design and Evaluation Technology of Advanced Implantable & Interventional Medical Devices, School of Biological Science and Medical Engineering, Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China., Zhao Y; Aerospace Center Hospital, Beijing, China., Pei B; Beijing Key Laboratory for Design and Evaluation Technology of Advanced Implantable & Interventional Medical Devices, School of Biological Science and Medical Engineering, Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China., Xu Y; Beijing Key Laboratory for Design and Evaluation Technology of Advanced Implantable & Interventional Medical Devices, School of Biological Science and Medical Engineering, Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China., Wu S; School of Big Data and Information, Shanxi College of Technology, Shanxi, China.
Jazyk: angličtina
Zdroj: Journal of orthopaedic research : official publication of the Orthopaedic Research Society [J Orthop Res] 2024 Mar; Vol. 42 (3), pp. 685-699. Date of Electronic Publication: 2023 Oct 20.
DOI: 10.1002/jor.25697
Abstrakt: Traditional growing rod (TGR) provides a corrective moment for deformed segments to straighten the spine, whose clinical efficacy has proven positive and growth-friendly. However, an insufficient understanding of orthopedic mechanisms can affect the development of clinical strategies. This research attempts to analyze the spine that has undergone four distraction operations: exploring the spinal orthopedic mechanism, including alignment, growth, and morphology. In this study, the spinal morphology curves were illustrated in three human planes to exhibit the changes in spinal alignment. The spinal growth characteristics were measured to discuss the unsynchronized and diminishing growth rate. The spinal deformations were evaluated to indicate asymmetric growth. As a result, the spinal alignment changes indicated the orthopedic process improved, but the re-unbalance occurred after multiple distractions. Then, unsynchronized growth existed in the superior and inferior segments, and the growth rate over every distraction diminished. Finally, asymmetric growth was indicated as the axial/circumferential growth ratio getting greater and the cuneate level approaching normal. Accordingly, a TGR is growth-friendly, but combining the osteotomy fusion of lumbar segments for severe early-onset scoliosis may be an excellent choice to solve the insufficient corrective stimulation. Regarding the distraction process, reshaping before the final fusion can fix the balance loss, and a prolonged distraction frequency fits the law of diminishing return. In conclusion, studying orthopedic mechanisms based on morphological measurement can guide clinical strategy optimization.
(© 2023 Orthopaedic Research Society.)
Databáze: MEDLINE
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