Comparison of surgical outcomes between early definitive fusion and traditional growing rod for juvenile scoliosis

DOI
  • Suzuki Teppei
    Department of Orthopaedic Surgery, National Hospital Organization Kobe Medical Center
  • Uno Koki
    Department of Orthopaedic Surgery, National Hospital Organization Kobe Medical Center
  • Kawakita Kohei
    Department of Orthopaedic Surgery, National Hospital Organization Kobe Medical Center
  • Ito Masaaki
    Department of Orthopaedic Surgery, National Hospital Organization Kobe Medical Center

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Other Title
  • 早期発症側弯症に対する早期固定術は骨未成熟であっても許容できるか―グローイングロッド手術との比較―

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Description

<p>Introduction: In juveniles with progressive curves, there is a controversy regarding the indication of early definitive fusion (EF) vs. traditional growing rod (TGR). The purpose of this study is to compare radiographic outcomes and complications of EF vs. TGR surgery for immature patients at a single institution.</p><p>Material: There were 16 patients treated by EF who met the following criteria: (1) diagnosis before 10 years old; (2) grade 0 of Risser sign; (3) had definitive spinal fusion at the age of 9-11 years; (4) excluding congenital scoliosis, neurofibromatosis. To compare the outcomes, 11 patients treated by TGR who underwent the initial surgery at the age of 9-11 years were included in this study. Average age at the initial surgery were 10.5±0.6, 10.5±0.8 years respectively (p=0.87). The magnitude of the major curve was 98±16, 92±23 degree respectively (p=0.42).</p><p>Results: Four patients in the group EF underwent staged surgeries. The average number of fused segments were 14±2, 15±1, respectively (p=0.18). Initial curve correction in the group EF was significantly greater than that in the group TGR after the initial surgery (60% vs. 40%; p<0.01). There was not significant difference in the overall correction rate of major curve (58% vs. 44%; p=0.12). The group EF maintained the thoracic kyphosis at latest follow-up better than the group TGR (34±15 vs. 56±29 degree; p=0.01). T1-12 height at latest follow-up were similar between the group EF and TGR (215±24 vs. 223±27 mm; p=0.42). Number of surgeries in the group EF was significantly lower than those in the group TGR (1.4±0.5 vs. 8.6±3.2; p<0.01).</p><p>Conclusion: While similar spinal growth was obtained in both groups, the number of operations could be reduced by EF. Early definitive spinal fusion might be a surgery of choice for 9- to 11-year-old children with EOS.</p>

Journal

  • Journal of Spine Research

    Journal of Spine Research 12 (11), 1319-1325, 2021-11-20

    The Japanese Society for Spine Surgery and Related Research

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