The effect of posterior distraction on vertebral growth in immature pigs: an experimental simulation of growing rod technique.

摘要

STUDY DESIGN: Experimental study. OBJECTIVE: The aim of this study is to evaluate the vertebral body growth under distraction forces in immature pigs treated with growing rod (GR) technique. SUMMARY OF BACKGROUND DATA: Distraction forces applied on growth plate of appendicular skeleton stimulate longitudinal growth. However, the effect of distraction forces on axial skeletal growth has not been fully investigated yet. METHODS: Twelve 10-week-old domestic pigs were used in this experimental model to simulate GR technique. Four of them were lost during postoperative period because of deep wound infection. Cranially T12-L1 and caudally L4-L5 vertebrae were instrumented by pedicle screws bilaterally, while L2 and L3 were skipped. Distraction between pedicle screws was applied at index surgery. The rods were then lengthened twice in a month interval. All subjects were evaluated with anteroposterior and lateral spinal radiograph before surgery, after surgery, and at the final follow-up. The vertebral body heights of distracted segments (HD = L2 and L3) and control segments (HC = T9, T10 and T11) were measured. Average vertebral body heights and the increase percentage in the vertebral body heights were compared among control segments and distracted segments. RESULTS: The preoperative vertebral body height was similar in 2 groups (preHC: 10.81 mm, n = 19, preHD: 11.27 mm, n = 16, P > 0.05). At the final follow-up, the average vertebral body height in distraction group was significantly higher than the control group (postHC: 17.03 mm, postHD: 18.58 mm, P < 0.05). The increase percentage in vertebral body height was higher in distracted segments, but there was no statistically significant difference between the 2 groups. CONCLUSION: The vertebral growth continues during GR instrumentation. Distraction forces might stimulate also apophyseal growth of axial skeleton.