Paper #2: Guided Growth System (GGS) in the Treatment of Early-Onset Scoliosis—5 Years' Follow-up

2014 ◽  
Vol 2 (6) ◽  
pp. 498-499 ◽  
Author(s):  
Michal Latalski ◽  
Marek Fatyga ◽  
Krzysztof Kołtowski ◽  
Anna Danielewicz-Bromberek ◽  
Piotr Menarowicz
Keyword(s):  
Early Onset ◽  
Early Onset Scoliosis ◽  
Guided Growth ◽  
Growth System

scholarly journals Analysis of serum levels of titanium and aluminium ions in patients with early onset scoliosis operated upon using the magnetic growing rod—a single centre study of 14 patients

2021 ◽  
Author(s):  
Mandar Deepak Borde ◽  
Sarang Sapare ◽  
Emile Schutgens ◽  
Chadi Ali ◽  
Hilali Noordeen
Keyword(s):  
Early Onset ◽  
Serum Levels ◽  
Early Onset Scoliosis ◽  
Ion Concentration ◽  
Long Term Effects ◽  
Blood Concentrations ◽  
Growing Rod ◽  
Rod System ◽  
Rod Breakage

Abstract Study design A cross-sectional retrospective Level 3 study. Objective To study the serum levels of Titanium and Aluminium ions in patients operated using the magnetically controlled growing rod (MCGR) system. Summary of background data 14 consecutive patients of early onset scoliosis with varying etiology managed with MCGR system with a minimum follow-up of 24 months were selected for the study. The group consisted of two boys (14.3%) and 12 girls (85.7%). The average age of the patients at the time of surgery was 10.4 years (5–15 years). The average period of follow-up was 43.7 months (28–79 months). After informed consent of the subjects and their caretakers, serum levels of titanium and aluminium were measured. These levels were then assessed with regards to the number of screws used, number of distractions and complications. Methods The concentration of titanium and aluminium ions in the serum was measured using high resolution inductively coupled plasma mass spectrometry. Results For the sake of ease of assessment, patients were divided into three etiology-based groups—idiopathic (n = 6), neuromuscular (n = 2) and syndromic (n = 6). The mean serum titanium level was 15.9 μg/L (5.1–28.2 μg/L) while that of aluminium was 0.1 μmol/L (0.1–0.2 μmol/L). Of the 14 patients, 2 (14.2%) patients had mechanical failure (actuator pin dysfunction), 3 (21.4%) had rod breakage requiring revision surgery and one patient (7.1%) had surgical site infection managed with appropriate antibiotics. Patients undergoing revision for rod breakage did not show any metallosis of the tissues during surgery. Conclusion Analysis of patients with scoliosis operated using the magnetic growing rod system concludes that it is accompanied by presence of titanium in the blood but whether clinically significant or not needs to be ascertained by comparison of preoperative and postoperative blood concentrations of the titanium ions in individual subjects. The aluminium ion concentration remains within normal limits. Though implant malfunction may raise the titanium levels in the blood, its clinical significance needs to be determined. The aluminium levels are not affected irrespective to the presence or absence of complications. The long-term effects of raised titanium levels in the blood also warrant further prospective studies designed for precise and deeper analyses.

scholarly journals Evaluation of changes in shoulder balance and prediction of final shoulder imbalance during growing-rod treatment for early-onset scoliosis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ziyang Liu ◽  
Tie Liu ◽  
Yong Hai ◽  
Lingyun Wu ◽  
Junrui Jonathan Hai ◽  
...  
Keyword(s):  
Early Onset ◽  
Demographic Data ◽  
Potential Effect ◽  
Early Onset Scoliosis ◽  
Shoulder Balance ◽  
Related Factors ◽  
Growing Rod ◽  
Shoulder Imbalance ◽  
Entire Treatment

Abstract Background Obtaining and maintaining final shoulder balance after the entire treatment course is essential for early-onset scoliosis (EOS) patients. The relatively small number of growing-rod (GR) graduates who complete final fusion has resulted in an overall paucity of research on the GR treatment of EOS and a lack of research on the shoulder balance of EOS patients during GR treatment. Methods Twenty-four consecutive patients who underwent GR treatment until final fusion were included. Radiographic shoulder balance parameters, including the radiographic shoulder height (RSH), clavicle angle (CA), and T1 tilt angle (T1T), before and after each step of the entire treatment were measured. Shoulder balance changes from GR implantation to the last follow-up after final fusion were depicted and analysed. Demographic data, surgical-related factors, and radiographic parameters were analysed to identify risk factors for final shoulder imbalance. The shoulder balance of patients at different time points was further analysed to explore the potential effect of the series of GR treatment steps on shoulder balance. Results The RSH showed substantial improvement after GR implantation (P = 0.036), during the follow-up period after final fusion (P = 0.021) and throughout the entire treatment (P = 0.011). The trend of change in the CA was similar to that of the RSH, and the T1T improved immediately after GR implantation (P = 0.037). Further analysis indicated that patients with shoulder imbalance before final fusion showed significantly improved shoulder balance after fusion (P = 0.045), and their RSH values at early postfusion and the final follow-up did not show statistically significant differences from those in the prefusion shoulder balance group (P > 0.05). Early postfusion shoulder imbalance (odds ratio (OR): 19.500; 95% confidence interval (CI) = 1.777–213.949; P = 0.015) was identified as an independent risk factor for final shoulder imbalance. Conclusions Shoulder balance could be improved by GR implantation but often changes during the multistep lengthening process, and the final result is relatively unpredictable. Final fusion could further adjust the prefusion shoulder imbalance. Focusing on the prefusion shoulder balance of GR graduates and providing patients with early shoulder balance after fusion might be necessary.

scholarly journals Self sliding growth guidance for early-onset scoliosis: Clinical and radiological results after a minimum of five years (5-13) of follow-up

2021 ◽  
Vol 1 ◽  
pp. 100146
Author(s):  
Mustafa Eltayep ◽  
Recep Dincer ◽  
Ahmet Ates ◽  
Sina Coskun ◽  
Ugur Tasci ◽  
...  
Keyword(s):  
Early Onset ◽  
Early Onset Scoliosis ◽  
Radiological Results ◽  
Growth Guidance ◽  
Clinical And Radiological Results

Mid-term results of a modified self-growing rod technique for the treatment of early-onset scoliosis

2020 ◽  
Vol 102-B (11) ◽  
pp. 1560-1566
Author(s):  
Hossein Mehdian ◽  
Sleiman Haddad ◽  
Dritan Pasku ◽  
Luigi Aurelio Nasto
Keyword(s):  
Cerebral Palsy ◽  
Cobb Angle ◽  
Early Onset ◽  
Early Onset Scoliosis ◽  
Growth Spurt ◽  
Spinal Growth ◽  
Growing Rod ◽  
The Mean ◽  
Mid Term Results

Aims To report the mid-term results of a modified self-growing rod (SGR) technique for the treatment of idiopathic and neuromuscular early-onset scoliosis (EOS). Methods We carried out a retrospective analysis of 16 consecutive patients with EOS treated with an SGR construct at a single hospital between September 2008 and December 2014. General demographics and deformity variables (i.e. major Cobb angle, T1 to T12 length, T1 to S1 length, pelvic obliquity, shoulder obliquity, and C7 plumb line) were recorded preoperatively, and postoperatively at yearly follow-up. Complications and revision procedures were also recorded. Only patients with a minimum follow-up of five years after surgery were included. Results A total of 16 patients were included. Six patients had an idiopathic EOS while ten patients had a neuromuscular or syndromic EOS (seven spinal muscular atrophy (SMA) and three with cerebral palsy or a syndrome). Their mean ages at surgery were 7.1 years (SD 2.2) and 13.3 years (SD 2.6) respectively at final follow-up. The mean preoperative Cobb angle of the major curve was 66.1° (SD 8.5°) and had improved to 25.5° (SD 9.9°) at final follow-up. The T1 to S1 length increased from 289.7 mm (SD 24.9) before surgery to 330.6 mm (SD 30.4) immediately after surgery. The mean T1 to S1 and T1 to T12 growth after surgery were 64.1 mm (SD 19.9) and 47.4 mm (SD 18.8), respectively, thus accounting for a mean T1 to S1 and T1 to T12 spinal growth after surgery of 10.5 mm/year (SD 3.7) and 7.8 mm/year (SD 3.3), respectively. A total of six patients (five idiopathic EOS, one cerebral palsy EOS) had broken rods during their growth spurt but were uneventfully revised with a fusion procedure. No other complications were noted. Conclusion Our data show that SGR is a safe and effective technique for the treatment of EOS in nonambulatory hypotonic patients with a neuromuscular condition. Significant spinal growth can be expected after surgery and is comparable to other published techniques for EOS. While satisfactory correction of the deformity can be achieved and maintained with this technique, a high rate of rod breakage was seen in patients with an idiopathic or cerebral palsy EOS. Cite this article: Bone Joint J 2020;102-B(11):1560–1566.

scholarly journals Spring distraction system for dynamic growth guidance of early onset scoliosis: two-year prospective follow-up of 24 patients

2020 ◽  
Author(s):  
Justin V.C. Lemans ◽  
Sebastiaan P.J. Wijdicks ◽  
René M. Castelein ◽  
Moyo C. Kruyt
Keyword(s):  
Early Onset ◽  
Early Onset Scoliosis ◽  
Growth Guidance ◽  
Dynamic Growth

Long-term Surgical Outcomes After Early Definitive Spinal Fusion for Early-onset Scoliosis With Neurofibromatosis Type 1 at Mean Follow-up of 14 Years

2020 ◽  
Vol 40 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Ryoji Tauchi ◽  
Noriaki Kawakami ◽  
Michael Anton Castro ◽  
Tetsuya Ohara ◽  
Toshiki Saito ◽  
...  
Keyword(s):  
Spinal Fusion ◽  
Neurofibromatosis Type 1 ◽  
Surgical Outcomes ◽  
Early Onset ◽  
Neurofibromatosis Type ◽  
Early Onset Scoliosis

scholarly journals Traditional growing rod for early-onset scoliosis in high-altitude regions: a retrospective study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Haijun Jiang ◽  
Junrui Jonathan Hai ◽  
Peng Yin ◽  
Qingjun Su ◽  
Shiqi Zhu ◽  
...  
Keyword(s):  
Cobb Angle ◽  
High Altitude ◽  
Early Onset ◽  
Repeated Measures ◽  
Early Onset Scoliosis ◽  
Sacral Slope ◽  
Growing Rods ◽  
Initial Surgery ◽  
Radiographic Measurements

Abstract Background Children with early-onset scoliosis living in high-altitude areas have severe deformities and poor nutritional status. However, no reports on early-onset scoliosis treatment using traditional growing rods in such children exist. Thus, we analyzed the outcomes of traditional growing rods treatment in such patients and the effect of altitude on therapy. Methods Between September 2007 and December 2017, 59 consecutive patients with EOS underwent systematic surgical correction using traditional growing rods. They were divided into the high-altitude and low-altitude groups, and differences in surgical efficacy and complications between the groups were analyzed pre- and postoperatively. Radiographic measurements, including the Cobb angle, thoracic kyphosis, lumbar lordosis, T1–S1 and T1–T12 heights, sagittal and coronal balance, distance between C7PL and sagittal vertical axis, pelvic incidence, sacral slope, and pelvic tilt were assessed preoperatively, postoperatively, and at the last follow-up. Continuous data were analyzed using paired or independent Student’s t tests, and they were compared preoperatively, postoperatively, and at the last follow-up using a repeated measures analysis of variance. Enumerated data were analyzed using the χ2 test. Results The mean patient age at the initial surgery and mean follow-up duration were 8.9 ± 2.4(5–14) years and 51.91 ± 25.23 months, respectively. Altogether, 234 operations were conducted for all patients with an average interval between operations of 11.4 ± 3.0 months. The average Cobb angle was similar in both groups preoperatively and at the last follow-up, it was significantly different postoperatively. TK was significantly different in all three periods. T1–S1 and T1–T12 heights were significantly different only during the preoperative period. The overall rates of complications and implant-related complications did not differ significantly between the groups. Conclusions Deformity in patients with EOS in high-altitude areas was more severe, and treatment using TGRs yielded a satisfactory therapeutic effect.

scholarly journals Posterior only instrumented fusion provides incomplete curve control for early-onset scoliosis in type 1 neurofibromatosis

2019 ◽  
Author(s):  
Jianguo zhang ◽  
Siyi Cai ◽  
zhenyao Li ◽  
Guixing Qiu ◽  
Jianxiong shen ◽  
...  
Keyword(s):  
Spinal Fusion ◽  
Early Onset ◽  
Neurofibromatosis Type ◽  
Posterior Spinal Fusion ◽  
Early Onset Scoliosis ◽  
Fusion Surgery ◽  
Major Curve

Abstract Background: The mid-long term outcomes of posterior spinal fusion in pediatric neurofibromatosis type 1 (NF-1) patients are rarely reported, so does the effectiveness of itsorthopeidc maintenance function. This study aims to evaluate the mid-long term surgical outcomes of posterior only instrumented spinal fusion for early-onset scoliosis (EOS) in NF-1 patients. Methods: A retrospective review was performed on a cohort of 10 NF-1 patients having EOS from 2008 to 2014 in our hospital, including four male and six female patients with an age averaged at 7.8 years old when they underwent posterior only instrumented spinal fusion for their EOS. Both general clinical data and surgical specific data of the patients were collected and reviewed, and the dystrophic progression of EOS was evaluated during the follow-up. Results: The average duration of follow-up was 54 months (24 to 88 months). All patients underwent posterior only instrumented spinal fusion at 1 stage. The primary curves of EOS were thoracic in 9 cases and 1 patient had lumbar scoliosis. Preoperative major curve was significantly corrected (from 66.1 to 31.1 degrees). However, the major curve deteriorated significantly to 40.1 degrees on average at the end of the follow-up. The T1-S1 distance increased 2.8 cm on average and kept increasing at a rate of 0.6cm/year during the follow-up. Conclusions: Posterior only fusion surgery was not a good option to treat the EOS in NF-1 patients despite the relatively short segments involvement in the disease. The maintenance of orthopedic effect after treatment was not satisfactory.

scholarly journals 3-Year follow-up of a single magnetically controlled growing rod with contralateral gliding system and apical control for early onset scoliosis

2020 ◽  
Vol 8 (4) ◽  
pp. 751-761 ◽  
Author(s):  
Sebastiaan P. J. Wijdicks ◽  
Simon Toftgaard Skov ◽  
Haisheng Li ◽  
René M. Castelein ◽  
Moyo C. Kruyt ◽  
...  
Keyword(s):  
Early Onset ◽  
Early Onset Scoliosis ◽  
Growing Rod ◽  
Apical Control ◽  
Magnetically Controlled Growing Rod
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