Treatment of early-onset scoliosis: Similar outcomes despite different etiologic subtypes in traditional growing rod graduates

The Pediatric Spine Study Group

Research output: Contribution to journalArticlepeer-review

Abstract

Background: It is unclear whether traditional growing rod (TGR) treatment outcomes vary by early-onset scoliosis (EOS) subtype. The goal of this study was to compare radiographic outcomes and complications of TGR treatment by EOS subtype. Methods: We queried an international database of EOS patients from 20 centers to identify “graduates” who had (1) undergone primary TGR treatment from 1993 to 2014; (2) completed TGR treatment; and (3) had an uneventful clinical examination within 6 months after completion of TGR treatment with no anticipated further intervention. We included 202 patients in 4 etiologic subgroups: neuromuscular (n = 65), syndromic (n = 57), idiopathic (n = 52), and congenital (n = 28). Mean age at surgery was 7.1 years (range, 1.6 to 14.9 y); mean duration of follow-up was 8 years (range, 2 to 18.6 y). The groups did not differ by mean age, body mass index, sex, number of lengthenings, or duration of follow-up. The following preoperative differences were significant: (1) greater mean major curve in the neuromuscular versus idiopathic subgroup; (2) shorter spinal height (T1-S1) in the congenital versus idiopathic subgroup; and (3) smaller proportion of ambulatory patients in the neuromuscular subgroup versus all other subgroups. Results: We found no significant differences among subgroups in mean major curve correction or changes in thoracic height (T1-T12), spinal height, or global kyphosis at any point. Rates of deep surgical site infection, implant-related complications, and neurological complications were not different among subgroups. The medical complication rate was significantly lower in the idiopathic group compared with the other groups. Conclusions: Major curve correction and spinal and thoracic height increases did not differ significantly at any point by EOS subtype. Rates of deep surgical site infection, implant-related

Original languageEnglish (US)
Pages (from-to)10-16
Number of pages7
JournalJournal of Pediatric Orthopaedics
Volume42
Issue number1
DOIs
StatePublished - Jan 1 2022

Keywords

  • Complications
  • Early-onset scoliosis
  • Etiologic subtype
  • Radiographic outcomes
  • Traditional growing rods

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine

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