@article{8c20b59b94a847a5a4023bf2e43fa9b8,
title = "Pelvic Obliquity Correction in Distraction-Based Growth Friendly Implants",
abstract = "Design: Multicenter retrospective review. Objective: To evaluate radiographic outcomes and complication rates of patients treated with distraction based implants and pelvic fixation with either screws (sacral-alar-iliac [SAI] screws or iliac screws) or hooks (S hook iliac fixation). Summary of Background Data: Multiple options exist for pelvic fixation in distraction-based growing rod systems; however, limited comparative data are available. Methods: Early-onset scoliosis (EOS) patients of all diagnoses with distraction-based implants that had pelvic fixation from 2000 to 2013 were reviewed from two EOS multicenter databases. Patients were divided into two groups by type of pelvic fixation: (1) screw group (SAI screws or iliac screws) or (2) S hooks. Exclusion criteria were as follows: index instrumentation ≥10 years old and follow up <2 years. A total of 153 patients met the inclusion criteria. Mean age at index surgery was 6.1 years (range 1.0-9.9 years) and mean follow-up was 4.9 years. Results: Pelvic fixation in the 153 patients was as follows: screw group = 42 and S hook group = 111. When comparing patients with >20° of initial pelvic obliquity, the screw group had significantly more correction; mean 26° ± 13° for the screw group versus mean 17° ± 7° in the S hook group (p = .039). There was no significant difference in change in T1–S1 length (40 vs. 39 mm, p = .89) or correction of Cobb angle (30° vs. 24°, p = .24). The total complication rate for the screw group was 14% (6/42) versus 25% (28/111) in the S hook group, though this did not achieve significance (p = .25). The most common complications were device migration (13), implant failure (8), and implant prominence (4) for S hooks and implant failure (3), implant prominence (2), and device migration (1) for the screw group. Conclusion: In distraction-based growth-friendly constructs, pelvic fixation with screws achieved better correction of pelvic obliquity than S hooks. Complications were almost twice as common with S hooks than screws, though this did not reach statistical significance.",
keywords = "Complications, Distraction-based growth friendly implants, Early onset scoliosis, Lumbar lordosis, Pelvic obliquity",
author = "{Growing Spine Study Group} and {Children's Spine Study Group} and Mathew Schur and Andras, {Lindsay M.} and Rajan Murgai and Siddiqui, {Ali A.} and Gonsalves, {Nicholas R.} and Sponseller, {Paul D.} and Emans, {John B.} and Vitale, {Michael G.} and Skaggs, {David L.}",
note = "Funding Information: Author disclosures: MS (none), LMA (personal fees from Biomet, Zimmer, Medtronic, NuVasive, and Orthobullets; other from Eli Lilly and the Journal of Pediatric Orthopedics; other from Pediatric Orthopaedic Society of North America [POSNA] and Scoliosis Research Society [SRS], outside the submitted work), RM (none), NRG (none), PDS (personal fees from DePuy Synthes Spine, Journal of Bone and Joint Surgery, and Globus, outside the submitted work), JBE (personal fees from Biomet and DePuy; other from the Journal of Pediatric Orthopedics; personal fees from Medtronic Sofamor Danek and Synthes, outside the submitted work), MGV (grants and personal fees from Biomet, grants and nonfinancial support from Children's Spine Foundation, personal fees from East Coast Orthotics and Prosthetics, other from FOX, nonfinancial support from IPOS, grants from, OREF grants and nonfinancial support from POSNA, nonfinancial support from Project for Safety in Spine Surgery, grants from OSRF, grants from SRS, personal fees from Stryker, nonfinancial support from Wellinks, outside the submitted work), DLS (grants from POSNA and SRS, paid to Columbia University; Ellipse [co-PI, paid to Growing Spine Foundation (GSF)], personal fees from ZimmerBiomet, Medtronic, Zipline Medical, Inc., Orthobullets, Grand Rounds [a healthcare navigation company], Green Sun Medical, other from Zipline Medical, Inc; Green Sun Medical, other from Orthobullets, nonfinancial support from the Growing Spine Study Group [GSSG], SRS, and GSF; personal fees from ZimmerBiomet, Medtronic, Johnson & Johnson, other from Medtronic and ZimmerBiomet, other from Wolters Kluwer Health–Lippincott Williams & Wilkins, Biomet Spine; other from Orthobullets, co-editor in chief, outside the submitted work), Growing Spine Study Group (grants from DePuy Synthes Spine, grants from NuVasive, outside the submitted work), Children's Spine Study Group (grants from DePuy Synthes Spine, grants from NuVasive, outside the submitted work). Publisher Copyright: {\textcopyright} 2019 Scoliosis Research Society",
year = "2019",
month = nov,
doi = "10.1016/j.jspd.2019.03.003",
language = "English (US)",
volume = "7",
pages = "985--991",
journal = "Spine deformity",
issn = "2212-134X",
publisher = "Elsevier BV",
number = "6",
}