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Outcomes of growing rod surgery for severe compared with moderate early-onset scoliosis.

Abstract Aims The aim of this study was to compare the outcomes of surgery using growing rods in patients with severe versus moderate early-onset scoliosis (EOS). Patients and Methods A review of a multicentre EOS database identified 107 children with severe EOS (major curve ≥ 90°) treated with growing rods before the age of ten years with a minimum follow-up of two years and three or more lengthening procedures. From the same database, 107 matched controls with moderate EOS were identified. Results The mean preoperative major curve was 101° (90 to 139) in the severe group and 67° (33° to 88°) in the moderate group (p < 0.001), which was corrected at final follow-up to 57° (10° to 96°) in the severe group and 40° (3° to 85°) in the moderate group (p < 0.001). T1-S1 height increased by a mean of 54 mm (-8 to 131) in the severe group and 27 mm (-4 to 131) in the moderate group at the initial surgery (p < 0.001), and by 50 mm (-17 to 200) and 54 mm (-11 to 212), respectively, during distraction (p = 0.84). The mean number of complications per patient was 2.6 (0 to 14) in the severe group and 1.9 (0 to 10) in the moderate group (p = 0.040). Five patients (4.7%) in the severe group and three (2.8%) in the moderate group developed a neurological deficit postoperatively (p = 0.47). Conclusion Severe EOS can be treated effectively using growing rods, but the risk of complications is high. Cite this article: Bone Joint J 2018;100-B:772-9.
PMID
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Authors

Mayor MeshTerms
Keywords

Complication

Growing rods

Neurological complications

Severe early-onset scoliosis

Journal Title the bone & joint journal
Publication Year Start




PMID- 29855249
OWN - NLM
STAT- MEDLINE
DCOM- 20180612
LR  - 20180612
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 100-B
IP  - 6
DP  - 2018 Jun 1
TI  - Outcomes of growing rod surgery for severe compared with moderate early-onset
      scoliosis.
PG  - 772-779
LID - 10.1302/0301-620X.100B6.BJJ-2017-1490.R1 [doi]
AB  - Aims The aim of this study was to compare the outcomes of surgery using growing
      rods in patients with severe versus moderate early-onset scoliosis (EOS).
      Patients and Methods A review of a multicentre EOS database identified 107
      children with severe EOS (major curve &gt;/= 90 degrees ) treated with growing rods 
      before the age of ten years with a minimum follow-up of two years and three or
      more lengthening procedures. From the same database, 107 matched controls with
      moderate EOS were identified. Results The mean preoperative major curve was 101
      degrees (90 to 139) in the severe group and 67 degrees (33 degrees to 88 degrees 
      ) in the moderate group (p &lt; 0.001), which was corrected at final follow-up to 57
      degrees (10 degrees to 96 degrees ) in the severe group and 40 degrees (3 degrees
      to 85 degrees ) in the moderate group (p &lt; 0.001). T1-S1 height increased by a
      mean of 54 mm (-8 to 131) in the severe group and 27 mm (-4 to 131) in the
      moderate group at the initial surgery (p &lt; 0.001), and by 50 mm (-17 to 200) and 
      54 mm (-11 to 212), respectively, during distraction (p = 0.84). The mean number 
      of complications per patient was 2.6 (0 to 14) in the severe group and 1.9 (0 to 
      10) in the moderate group (p = 0.040). Five patients (4.7%) in the severe group
      and three (2.8%) in the moderate group developed a neurological deficit
      postoperatively (p = 0.47). Conclusion Severe EOS can be treated effectively
      using growing rods, but the risk of complications is high. Cite this article:
      Bone Joint J 2018;100-B:772-9.
FAU - Helenius, I J
AU  - Helenius IJ
AD  - University of Turku, Turku University Hospital, Turku, Finland and Consultant
      Orthopaedic Spine Surgeon, Spine Unit, Rigshospitalet and University of
      Copenhagen, Copenhagen, Denmark.
FAU - Oksanen, H M
AU  - Oksanen HM
AD  - University of Turku and Turku University Hospital, Turku, Finland.
FAU - McClung, A
AU  - McClung A
AD  - Growing Spine Foundation, Milwaukee, Wisconsin, USA.
FAU - Pawelek, J B
AU  - Pawelek JB
AD  - Growing Spine Foundation, San Diego, California, USA.
FAU - Yazici, M
AU  - Yazici M
AD  - Hacettepe University, Faculty of Medicine, Ankara, Turkey.
FAU - Sponseller, P D
AU  - Sponseller PD
AD  - The Johns Hopkins University, Baltimore, Maryland, USA.
FAU - Emans, J B
AU  - Emans JB
AD  - Children's Hospital Boston, Boston, Massachusetts, USA.
FAU - Sanchez Perez-Grueso, F J
AU  - Sanchez Perez-Grueso FJ
AD  - Spine Surgery Unit Hospital, Universitario La Paz, Madrid, Spain.
FAU - Thompson, G H
AU  - Thompson GH
AD  - Rainbow Babies and Children's Hospital, Case Western Reserve University,
      Cleveland, Ohio, USA.
FAU - Johnston, C
AU  - Johnston C
AD  - Texas Scottish Rite Hospital, Dallas, Texas, USA.
FAU - Shah, S A
AU  - Shah SA
AD  - Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA.
FAU - Akbarnia, B A
AU  - Akbarnia BA
AD  - University of California San Diego, California, USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PL  - England
TA  - Bone Joint J
JT  - The bone &amp; joint journal
JID - 101599229
SB  - AIM
SB  - IM
MH  - Bone Lengthening/adverse effects/*methods
MH  - Child
MH  - Child, Preschool
MH  - Databases, Factual
MH  - Female
MH  - Humans
MH  - Infant
MH  - Magnets
MH  - Male
MH  - Orthopedic Fixation Devices/*adverse effects
MH  - Postoperative Complications/epidemiology
MH  - Prosthesis Design/*adverse effects
MH  - Retrospective Studies
MH  - Scoliosis/*surgery
MH  - Severity of Illness Index
MH  - Spinal Fusion/methods
MH  - Spine/*surgery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Complication
OT  - Growing rods
OT  - Neurological complications
OT  - Severe early-onset scoliosis
EDAT- 2018/06/02 06:00
MHDA- 2018/06/13 06:00
CRDT- 2018/06/02 06:00
PHST- 2018/06/02 06:00 [entrez]
PHST- 2018/06/02 06:00 [pubmed]
PHST- 2018/06/13 06:00 [medline]
AID - 10.1302/0301-620X.100B6.BJJ-2017-1490.R1 [doi]
PST - ppublish
SO  - Bone Joint J. 2018 Jun 1;100-B(6):772-779. doi:
      10.1302/0301-620X.100B6.BJJ-2017-1490.R1.