Knifeless Limb Lengthening: Critical Advancement of an Innovative Therapy

项目摘要/摘要 在美国，每年有超过4万名儿童因肌肉骨骼畸形而住院。不正常且经常 骨骼生长减慢是许多此类疾病的根本原因。多年来，骨膜切除术 已被证明可以加速纵向骨骼的生长。之前试图通过外科手术来利用这一现象 作为一种加速生长的治疗方式，产生了不同的结果，这并不证明 手术并发症多，一直是临床广泛应用的主要障碍。最近，我们有 开发的技术能够非侵入性地执行这些程序。然而，目前 技术缺乏必要的定向和成像能力来测量和确保适当的能量 在骨骼表面投放。此外，骨膜的确切部分必须损伤到 加速增长尚不明朗。因此，在第一个目的中，我们将确定损伤的骨膜的成分 在开放手术中，骨膜切除可以加速骨赘生长，第二个目标是我们 将靶向功能集成到我们的系统中，以便精确地将能量放置在骨膜上 最大限度地减少邻近软组织损伤。在完成拟议的工作后，我们将进一步实现我们的目标 开发一种简单、非侵入性的方法来调节骨骼生长。

PROJECT SUMMARY/ABSTRACT Over 40,000 children in the US are hospitalized for musculoskeletal deformities each year. Abnormal and often diminished skeletal growth is the root cause of many of these conditions. For years, periosteal resection has been shown to accelerate longitudinal bone growth. Previous attempts to surgically exploit this phenomenon as a growth accelerating therapeutic modality have produced variable results that have not justified the procedures’ surgical morbidity and has been a major barrier to widespread clinical use. Recently, we have developed technology capable of performing these procedures non-invasively. However, the current technology lacks the necessary targeting and imaging capabilities to measure and ensure proper energy delivery at the bone surface. Furthermore, the exact portion of the periosteum that must be injured to accelerate growth is unclear. Thus, in the first aim we will determine the component of the periosteum injured during open surgical periosteal resection responsible for physeal growth acceleration and in the second aim we will integrate targeting capabilities into our system to allow precise placement of energy on the periosteum to minimize adjacent soft tissue injury. At the completion of the proposed work, we will have furthered our goal of developing a simple, non-invasive method to modulate skeletal growth.