TY - JOUR
T1 - Growing rods versus Shilla growth guidance
T2 - Better Cobb angle correction and t1-s1 length increase but more surgeries
AU - Andras, Lindsay M.
AU - Joiner, Elizabeth R.A.
AU - McCarthy, Richard E.
AU - McCullough, Lynn
AU - Luhmann, Scott J.
AU - Sponseller, Paul D.
AU - Emans, John B.
AU - Barrett, Kody K.
AU - Skaggs, David L.
N1 - Funding Information:
A research grant was provided by the Growing Spine Foundation .
Funding Information:
Author disclosures: LMA (none); ERAJ (none); REM (Medtronic consultant; tracking courses; royalties; planning sessions); SJL (none); PDS (none); JBE (personal fees from Medtronics, Synthes Spine, outside the submitted work); KKB (none); DLS (grants from POSNA, SRS; personal fees from Biomet ; Medtronic , non-financial support from Growing Spine Study Group , Scoliosis Research Society , Growing Spine Foundation Medtronic Strategic Advisory Board ; personal fees from expert testimony, Biomet, Medtronic, Stryker, Wolters Kluwer Health–Lippincott Williams & Wilkins; other from Medtronic, Stryker, Biomet, Medtronic, outside the submitted work; patent from Medtronic).
Publisher Copyright:
© 2015 Scoliosis Research Society.
Copyright:
Copyright 2015 Elsevier B.V., All rights reserved.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Study Design Retrospective comparison. Objectives To compare treatment of early-onset scoliosis (EOS) with Shilla growth guidance versus distraction-based dual growing rods (GR). Summary of Background Data We are not aware of any prior studies comparing the Shilla procedure with other surgical procedures in the treatment of EOS. Methods The authors performed a multicenter case-matched comparison of patients with EOS treated with Shilla versus dual spine-spine GR from 1995 to 2009. A total of 36 Shilla patients from 3 centers were matched with 36 GR patients from the database by age at index surgery (±1 year), preoperative Cobb angle (±15°), and diagnosis (neuromuscular, congenital, idiopathic, or syndromic). Average follow-up was similar between groups (GR, 4.3 years; Shilla, 4.6 years; p =.353). Results Average Cobb angle improvement preoperatively to latest follow-up was 36° (range, 72° to 36°) in the GR group versus 23° (range, 69° to 45°) in the Shilla group (p =.0124). T1-S1 length increased 8.8 cm in patients treated with GR, compared with 6.4 cm in Shilla patients (p =.0170). Shilla patients had fewer surgeries (2.8) than patients in the GR group (7.4) (p <.001) but had a higher rate of unplanned surgeries for implant complications (Shilla, 1.3; GR, 0.5; p =.0151). When revisions for implant complications done at the time of scheduled lengthenings and revisions for construct maintenance were included, the groups did not differ significantly in the number of procedures for implant complications (Shilla, 1.4; GR, 1.5; p =.9451). The overall complication rate did not differ significantly between groups (Shilla, 1.9 [range, 0-7]; GR, 1.3 [range, 0-9]; p =.2085). Conclusions The GR group had a greater improvement in Cobb angle and a greater increase in T1-S1 length than Shilla. The GR patients had more surgeries but Shilla patients had more unplanned procedures. The rate of complications overall did not differ significantly between groups.
AB - Study Design Retrospective comparison. Objectives To compare treatment of early-onset scoliosis (EOS) with Shilla growth guidance versus distraction-based dual growing rods (GR). Summary of Background Data We are not aware of any prior studies comparing the Shilla procedure with other surgical procedures in the treatment of EOS. Methods The authors performed a multicenter case-matched comparison of patients with EOS treated with Shilla versus dual spine-spine GR from 1995 to 2009. A total of 36 Shilla patients from 3 centers were matched with 36 GR patients from the database by age at index surgery (±1 year), preoperative Cobb angle (±15°), and diagnosis (neuromuscular, congenital, idiopathic, or syndromic). Average follow-up was similar between groups (GR, 4.3 years; Shilla, 4.6 years; p =.353). Results Average Cobb angle improvement preoperatively to latest follow-up was 36° (range, 72° to 36°) in the GR group versus 23° (range, 69° to 45°) in the Shilla group (p =.0124). T1-S1 length increased 8.8 cm in patients treated with GR, compared with 6.4 cm in Shilla patients (p =.0170). Shilla patients had fewer surgeries (2.8) than patients in the GR group (7.4) (p <.001) but had a higher rate of unplanned surgeries for implant complications (Shilla, 1.3; GR, 0.5; p =.0151). When revisions for implant complications done at the time of scheduled lengthenings and revisions for construct maintenance were included, the groups did not differ significantly in the number of procedures for implant complications (Shilla, 1.4; GR, 1.5; p =.9451). The overall complication rate did not differ significantly between groups (Shilla, 1.9 [range, 0-7]; GR, 1.3 [range, 0-9]; p =.2085). Conclusions The GR group had a greater improvement in Cobb angle and a greater increase in T1-S1 length than Shilla. The GR patients had more surgeries but Shilla patients had more unplanned procedures. The rate of complications overall did not differ significantly between groups.
KW - Dual growing rods
KW - Early-onset scoliosis
KW - Shilla
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U2 - 10.1016/j.jspd.2014.11.005
DO - 10.1016/j.jspd.2014.11.005
M3 - Article
C2 - 27927466
AN - SCOPUS:84928787386
SN - 2212-134X
VL - 3
SP - 246
EP - 252
JO - Spine deformity
JF - Spine deformity
IS - 3
ER -