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Characterizing Use of Growth-friendly Implants for Early-onset Scoliosis: A 10-Year Update.
Klyce, Walter; Mitchell, Stuart L; Pawelek, Jeff; Skaggs, David L; Sanders, James O; Shah, Suken A; McCarthy, Richard E; Luhmann, Scott J; Sturm, Peter F; Flynn, John M; Smith, John T; Akbarnia, Behrooz A; Sponseller, Paul D.
Afiliação
  • Klyce W; Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD.
  • Mitchell SL; Department of Orthopaedic Surgery, Case Western Reserve University, Cleveland.
  • Pawelek J; Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD.
  • Skaggs DL; Growing Spine Foundation.
  • Sanders JO; Children's Orthopedic Center, Children's Hospital Los Angeles, Los Angeles, CA.
  • Shah SA; Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • McCarthy RE; Department of Orthopedic Surgery, Nemours/Alfred I. DuPont Hospital for Children, Wilmington, DE.
  • Luhmann SJ; Department of Orthopaedics and Neurosurgery, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, AR.
  • Sturm PF; Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO.
  • Flynn JM; Division of Orthopaedic Surgery, Cincinnati Children's Hospital, Cincinnati, OH.
  • Smith JT; Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA.
  • Akbarnia BA; Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA.
  • Sponseller PD; Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, UT.
J Pediatr Orthop ; 40(8): e740-e746, 2020 Sep.
Article em En | MEDLINE | ID: mdl-32467421
BACKGROUND: Growth-friendly treatment of early-onset scoliosis (EOS) has changed with the development and evolution of multiple devices. This study was designed to characterize changes in the use of growth-friendly implants for EOS from 2007 to 2017. METHODS: We queried the Pediatric Spine Study Group database for patients who underwent index surgery with growth-friendly implants from July 2007 to June 2017. In 1298 patients, we assessed causes of EOS; preoperative curve magnitude; age at first surgery; patient sex; construct type; lengthening interval; incidence of "final" fusion for definitive treatment; and age at definitive treatment. α=0.05. RESULTS: From 2007 to 2017, the annual proportion of patients with idiopathic EOS increased from 12% to 33% (R=0.58, P=0.006). Neuromuscular EOS was the most common type at all time points (range, 33% to 44%). By year, mean preoperative curve magnitude ranged from 67 to 77 degrees, with no significant temporal changes. Mean (±SD) age at first surgery increased from 6.1±2.9 years in 2007 to 7.8±2.5 years in 2017 (R=0.78, P<0.001). As a proportion of new implants, magnetically controlled growing rods increased from <5% during the first 2 years to 83% in the last 2 years of the study. Vertically expandable prosthetic titanium ribs decreased from a peak of 48% to 6%; growth-guidance devices decreased from 10% to 3%. No change was seen in mean surgical lengthening intervals (range, 6 to 9 mo) for the 614 patients with recorded lengthenings. Final fusion was performed in 88% of patients who had undergone definitive treatment, occurring at a mean age of 13.4±2.4 years. CONCLUSIONS: From 2007 to 2017, neuromuscular EOS was the most common diagnosis for patients treated with growth-friendly implants. Patient age at first surgery and the use of magnetically controlled growing rods increased during this time. Preoperative curve magnitude, traditional growing rod lengthening intervals, and rates of final fusion did not change. LEVEL OF EVIDENCE: Level II.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Próteses e Implantes / Escoliose / Fusão Vertebral / Coluna Vertebral / Vértebras Torácicas Tipo de estudo: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: J Pediatr Orthop Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Próteses e Implantes / Escoliose / Fusão Vertebral / Coluna Vertebral / Vértebras Torácicas Tipo de estudo: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: J Pediatr Orthop Ano de publicação: 2020 Tipo de documento: Article