Spinal height for growth guidance treatment in early onset idiopathic scoliosis: analysis through final surgical treatment.

IF 1.6 Q3 CLINICAL NEUROLOGY

Spine deformity Pub Date : 2024-09-01 Epub Date: 2024-05-15 DOI:10.1007/s43390-024-00891-2

Meg Cornaghie, David Bumpass, Lauren Roeder, Eric R Siegel, Richard McCarthy

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引用次数: 0

Abstract

Background: The growth guidance (GG) method for treatment of early onset scoliosis has as its primary goal the restoration of apical spinal alignment, facilitating normal spinal growth to achieve a suitable adult thoracic height.

Purpose: To evaluate whether GG surgical treatment achieves comparable thoracic and spinal height to distraction-based treatment (DBT) in idiopathic early onset scoliosis (I-EOS) patients. We hypothesized that GG would prove superior to DBT at the time of definitive fusion surgery.

Methods: All I-EOS patients who underwent GG at a single center were reviewed. T1-L1 and T1-S1 heights were measured using the traditional coronal method as well as the Halifax sagittal spinal length (SSL) technique. The same measurements were obtained from a comparable control group obtained from a multi-center pediatric early onset scoliosis database who underwent treatment with traditional growing rods (TGR) or magnetically controlled growing rods (MCGR).

Results: Of the I-EOS patients who underwent GG 2004-2019, 15 patients underwent final fusion after GG completion, with a mean 5.5 years of GG treatment prior to fusion (range 2.0-11.4 years). Mean age at GG implantation was 8.4 years (range 2.0-11.7 years); 7 were male and 8 female. GG patients experienced a mean coronal thoracic height increase of 6.2 cm during treatment through final fusion, and a mean coronal spinal height increase of 8.8 cm. At the time of final fusion, GG patients achieved greater significant mean increases than DBT patients by 2.9 cm in coronal thoracic height (p = 0.0023), 4.5 cm in coronal spinal height (p = 0.001), and 4.0 cm in SSL spinal height (p = 0.01). No GG patient concluded treatment with a thoracic height less than 18 cm in either coronal or sagittal plane.

Conclusions: Not only did 100% of GG patients reach minimum thoracic height of 18 cm at time of final fusion, but GG also proved to be superior to distraction-based constructs in a comparison cohort on 3 of 4 spinal elongation measures.

Level of evidence: 3.

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用于早期特发性脊柱侧凸生长指导治疗的脊柱高度：通过最终手术治疗进行分析。

背景：目的：评估在特发性早发脊柱侧凸（I-EOS）患者中，GG手术治疗是否能达到与牵张治疗（DBT）相当的胸椎和脊柱高度。我们假设，在进行最终融合手术时，GG 将被证明优于 DBT：我们回顾了在一个中心接受 GG 治疗的所有 I-EOS 患者。采用传统的冠状法和哈利法克斯矢状脊柱长度（SSL）技术测量了 T1-L1 和 T1-S1 高度。从多中心儿科早发脊柱侧凸数据库中获得的可比对照组也进行了同样的测量，这些对照组接受了传统生长棒（TGR）或磁控生长棒（MCGR）治疗：在2004-2019年接受GG治疗的I-EOS患者中，15名患者在完成GG治疗后进行了最终融合，融合前接受GG治疗的平均年龄为5.5年（范围为2.0-11.4年）。植入 GG 时的平均年龄为 8.4 岁（范围为 2.0-11.7 岁）；其中 7 人为男性，8 人为女性。从治疗到最终融合，GG 患者的胸椎冠状面高度平均增加了 6.2 厘米，脊柱冠状面高度平均增加了 8.8 厘米。在最终融合时，GG 患者的胸椎冠状位高度比 DBT 患者显著增加了 2.9 厘米（p = 0.0023），脊柱冠状位高度增加了 4.5 厘米（p = 0.001），SSL 脊柱高度增加了 4.0 厘米（p = 0.01）。无论是冠状面还是矢状面，没有一名 GG 患者在治疗结束时胸廓高度低于 18 厘米：结论：不仅100%的GG患者在最终融合时达到18厘米的最低胸椎高度，而且在4项脊柱伸长测量中的3项上，GG也被证明优于以牵引为基础的比较队列：3.

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Spine deformity

CiteScore

3.20

自引率

18.80%

发文量

167

期刊介绍： Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.