E. Keykhosravi, H. Rezaee, Amin Tavallaii, Mohammad Abouei Mehrizi, A. Pourbagher-Shahri, Vahid Khajereza Shahri, Ahmad Abdul Sater Abdul Sater
{"title":"The Efficiency of Epiphysiodesis for Growth Modulation in Patients with Congenital Scoliosis: A Systematic Review","authors":"E. Keykhosravi, H. Rezaee, Amin Tavallaii, Mohammad Abouei Mehrizi, A. Pourbagher-Shahri, Vahid Khajereza Shahri, Ahmad Abdul Sater Abdul Sater","doi":"10.22038/IJP.2021.56414.4434","DOIUrl":null,"url":null,"abstract":"Purpose: Congenital scoliosis (CS) is a challenging entity in spinal surgery. Convex growth arrest (CGA) is a therapeutic method aiming at inhibiting growth on the curve convexity while remained growth of concavity corrects the scoliotic curve over time. In the view of controversies in current clinical studies for efficiency of CGA in CS patients, we performed a systematic review of the literature to clarify the debate. Methods: A comprehensive literature search was performed to identify studies assessing CGA outcome in CS patients, in following databases and search engines: Ovid MEDLINE, PubMed, Scopus, Cochrane Central Register of Controlled Trials (CCTR), EMBASE, Google Scholar, and Web of Science. Two authors screened the search results and selected the studies by the supervision of senior authors.Results: In 19 studies, enrolling 363 patients, age at surgery was 58.76 months ranging from 4 to 216 months. Anterior and posterior hemiepiphysiodesis was the most common approach. Eight studies added instrumentation to CGA. Follow-up mean was 64.57 months. Nine studies reported true epiphysiodesis effect (postoperative and final follow-up CCA difference): of 162 patients, 69 improved, 59 stabilized, and 34 progressed. Other studies reported preoperative and final follow-up CCA difference: of 88 patients, 49 improved, 32 stabilized, and 7 progressed. Preoperative curve magnitude, sagittal plane deformities, age <5 years, and type of spinal anomalies did not affect CGA outcome. Instrumentation was preferred in complicated spinal anomalies and older ages.Conclusion: CGA alone or with instrumentation is a feasible CS treatment, however criteria for choosing suitable candidates need reconsideration.","PeriodicalId":51591,"journal":{"name":"International Journal of Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2021-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.22038/IJP.2021.56414.4434","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Congenital scoliosis (CS) is a challenging entity in spinal surgery. Convex growth arrest (CGA) is a therapeutic method aiming at inhibiting growth on the curve convexity while remained growth of concavity corrects the scoliotic curve over time. In the view of controversies in current clinical studies for efficiency of CGA in CS patients, we performed a systematic review of the literature to clarify the debate. Methods: A comprehensive literature search was performed to identify studies assessing CGA outcome in CS patients, in following databases and search engines: Ovid MEDLINE, PubMed, Scopus, Cochrane Central Register of Controlled Trials (CCTR), EMBASE, Google Scholar, and Web of Science. Two authors screened the search results and selected the studies by the supervision of senior authors.Results: In 19 studies, enrolling 363 patients, age at surgery was 58.76 months ranging from 4 to 216 months. Anterior and posterior hemiepiphysiodesis was the most common approach. Eight studies added instrumentation to CGA. Follow-up mean was 64.57 months. Nine studies reported true epiphysiodesis effect (postoperative and final follow-up CCA difference): of 162 patients, 69 improved, 59 stabilized, and 34 progressed. Other studies reported preoperative and final follow-up CCA difference: of 88 patients, 49 improved, 32 stabilized, and 7 progressed. Preoperative curve magnitude, sagittal plane deformities, age <5 years, and type of spinal anomalies did not affect CGA outcome. Instrumentation was preferred in complicated spinal anomalies and older ages.Conclusion: CGA alone or with instrumentation is a feasible CS treatment, however criteria for choosing suitable candidates need reconsideration.
期刊介绍:
International Journal of Pediatrics is a peer-reviewed, open access journal that publishes original researcharticles, review articles, and clinical studies in all areas of pediatric research. The journal accepts submissions presented as an original article, short communication, case report, review article, systematic review, or letter to the editor.