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.
Original language | English (US) |
---|---|
Pages (from-to) | 10-16 |
Number of pages | 7 |
Journal | Journal of Pediatric Orthopaedics |
Volume | 42 |
Issue number | 1 |
DOIs | |
State | Published - 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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In: Journal of Pediatric Orthopaedics, Vol. 42, No. 1, 01.01.2022, p. 10-16.
Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Treatment of early-onset scoliosis
T2 - Similar outcomes despite different etiologic subtypes in traditional growing rod graduates
AU - The Pediatric Spine Study Group
AU - Akbarnia, Behrooz A.
AU - Pawelek, Jeff B.
AU - Hosseini, Pooria
AU - Salari, Pooria
AU - Kabirian, Nima
AU - Marks, David
AU - Shah, Suken A.
AU - Skaggs, David L.
AU - Emans, John B.
AU - Elsebaie, Hazem
AU - Thompson, George H.
AU - Sponseller, Paul D.
N1 - Funding Information: D.L.S.—Research grants: NuVasive (co-principal investigator, paid to Growing Spine Foundation); Consulting: ZimmerBiomet, Grand Rounds, Orthobullets; Stocks options: Green Sun Medical; Stocks: Orthobullets; Board membership: Growing Spine Study Group, Growing Spine Foundation, CHLA Foundation; Paid lecturer: ZimmerBiomet; Patents: Medtronic & ZimmerBiomet; Royalties: Wolters Kluwer Health, ZimmerBiomet; Editor: Orthobullets, Co-Editor in Chief; Editorial boards: Spine Deformity, Orthopedics Today, Journal of Children’s Orthopedics. J.B.E. —Royalties: Synthes/DePuy/Johnson and Johnson; Paid consultant: Zimmer Biomet; Unpaid consultant: Medtronics; Board member/committee: Growing Spine Foundation. G.H.T.—Royalties: OrthoPediatrics; Paid employee: Shriners Hospitals for Children, Wolters Kluwer; Paid consultant: OrthoPediatrics; Stock or stock options: OrthoPediatrics; Board member: Historian—SRS, Chairman of the Board SICOT Foundation; Travel expenses: NuVasive. BA Akbarnia—Royalties: K2M, DePuy Synthes, Springer, NuVasive; Board member/committee: Pediatric Spine Foundation, San Diego Spine Foundation, Spine, Spine Deformity; Stock/stock options: NociMed, Viseon. J.B.P.—Board member/committee: San Diego Spine Foundation, Growing Spine Committee of the Scoliosis Research Society. P.H.—Board member/committee: Gavin Journal of Orthopaedic Research and Therapy, Scoliosis Research Society, Society of Lateral Access Surgery. D.M.—Royalties: DePuy Spine. S.A.S.—Royalties: DePuy Synthes Spine, K2M, Springer; Paid consultant: DePuy Synthes Spine, EOS Imaging, Globus Medical, NuVasive; Research support: DePuy Synthes Spine, K2M, NuVasive (all via the Setting Scoliosis Straight Foundation); Board member/committee: AAOS, Pediatric Orthopaedic Society of North America, Scoliosis Research Society, Setting Scoliosis Straight Foundation. P.D.S.—Royalties: DePuy, Globus Medical, Journal of Bone and Joint Surgery American; Paid consultant: DePuy; Research support: DePuy; Board member/committee: Journal of Bone and Joint Surgery, Scoliosis Research Society; Other: OrthoPediatrics. B.A.A.: (1) Developed the conception and design of the work; interpretation of data; (2) drafted the work or revised it critically for important intellectual content; (3) approved the version to be published; and (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. J.B.P.: (1) made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work; (2) drafted the work or revised it critically for important intellectual content; (3) approved the version to be published; and (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. P.H.: (1) made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work; (2) drafted the work or revised it critically for important intellectual content; (3) approved the version to be published; and (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. P.S.: (1) made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work; (2) drafted the work or revised it critically for important intellectual content; (3) approved the version to be published; and (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. N.K.: (1) made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work; (2) drafted the work or revised it critically for important intellectual content; (3) approved the version to be published; and (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. D.M.: (1) made substantial contributions to the conception or design of the work; or analysis, or interpretation of data; (2) drafted the work or revised it critically for important intellectual content; (3) approved the version to be published; and (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. S.A.S.: (1) made substantial contributions to the conception or design of the work; or analysis, or interpretation of data; (2) drafted the work or revised it critically for important intellectual content; (3) approved the version to be published; and (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. D.L.S.: (1) made substantial contributions to the conception or design of the work; or analysis, or interpretation of data; (2) drafted the work or revised it critically for important intellectual content; (3) approved the version to be published; and (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. J.B.E.: (1) made substantial contributions to the conception or design of the work; or analysis, or interpretation of data; or the creation of new s (2) drafted the work or revised it critically for important intellectual content; (3) approved the version to be published; and (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. H.E.: (1) made substantial contributions to interpretation of data; (2) drafted the work or revised it critically for important intellectual content; (3) approved the version to be published; and (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. G.H.T.: (1) made substantial contributions to the conception or design of the work; or analysis, or interpretation of data; (2) drafted the work or revised it critically for important intellectual content; (3) approved the version to be published; and (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. P.D.S.: (1) made substantial contributions to the conception or design of the work; or analysis, or interpretation of data; (2) drafted the work or revised it critically for important intellectual content; (3) approved the version to be published; and (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Publisher Copyright: Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - 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.
AB - 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.
KW - Complications
KW - Early-onset scoliosis
KW - Etiologic subtype
KW - Radiographic outcomes
KW - Traditional growing rods
UR - http://www.scopus.com/inward/record.url?scp=85119423002&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85119423002&partnerID=8YFLogxK
U2 - 10.1097/BPO.0000000000001985
DO - 10.1097/BPO.0000000000001985
M3 - Article
C2 - 34739435
AN - SCOPUS:85119423002
SN - 0271-6798
VL - 42
SP - 10
EP - 16
JO - Journal of Pediatric Orthopaedics
JF - Journal of Pediatric Orthopaedics
IS - 1
ER -