Arun R Hariharan1, Suken A Shah2, Paul D Sponseller3, Burt Yaszay4, Michael P Glotzbecker5, George H Thompson5, Patrick J Cahill6, Tracey P Bastrom7. 1. Paley Orthopedic & Spine Institute, West Palm Beach, FL, USA. 2. Department of Orthopaedics, Nemours Children's Hospital, 1600 Rockland Road, Wilmington, DE, 19803, USA. Suken.Shah@nemours.org. 3. Johns Hopkins Hospital, Baltimore, MD, USA. 4. Seattle Children's Hospital, Seattle, WA, USA. 5. Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA. 6. Children's Hospital of Philadelphia, Philadelphia, PA, USA. 7. Rady Children's Hospital, San Diego, CA, USA.
Abstract
PURPOSE: This study compared the outcomes of juvenile patients with cerebral palsy (CP) and scoliosis who underwent spinal fusion (SF) versus growing rod (GR) surgery. METHODS: Two prospective multicenter registries were queried for patients 8-10 years old with minimum 2-year follow-up who underwent SF or GR surgery (no MCGR). Demographics, radiographs, complications, and outcome scores were recorded. RESULTS: There were 35 patients in the SF and 15 in the GR group. The mean age at surgery was 10 and 9.3 years in the SF and GR groups, respectively (p = 0.004). In the SF group preoperatively, the major curve measured 86° and 80° in the GR group (p = 0.40). "Definitive" surgery in the GR group consisted of SF in 10, implant retention in three, and implant removal in two. The SF group had 60.8% and the GR group had 45.0% correction following "definitive" surgery (p = 0.03). In the SF group, 8 patients and in the GR group, 9 patients (SF = 22.9%, GR = 60.0%) had a complication (p = 0.01). In the SF group, two patients (5.7%) had reoperations for infection; eight patients (53.3%) in the GR group had reoperations for infection and implant complications (p < 0.001). In the SF group, 23/30 parents (76.6%) noted that the child's life "improved a lot." In the GR group, 3/6 parents (50.0%) noted they were "neutral" about their child's ability to do things, 2/6 (33.3%) were "very dissatisfied." CONCLUSIONS: SF treatment for juvenile patients with CP and scoliosis resulted in fewer complications and unplanned reoperations and better radiographic outcomes compared with GR. Quality of life improvements were also better in the SF group. LEVEL OF EVIDENCE: Level III.
PURPOSE: This study compared the outcomes of juvenile patients with cerebral palsy (CP) and scoliosis who underwent spinal fusion (SF) versus growing rod (GR) surgery. METHODS: Two prospective multicenter registries were queried for patients 8-10 years old with minimum 2-year follow-up who underwent SF or GR surgery (no MCGR). Demographics, radiographs, complications, and outcome scores were recorded. RESULTS: There were 35 patients in the SF and 15 in the GR group. The mean age at surgery was 10 and 9.3 years in the SF and GR groups, respectively (p = 0.004). In the SF group preoperatively, the major curve measured 86° and 80° in the GR group (p = 0.40). "Definitive" surgery in the GR group consisted of SF in 10, implant retention in three, and implant removal in two. The SF group had 60.8% and the GR group had 45.0% correction following "definitive" surgery (p = 0.03). In the SF group, 8 patients and in the GR group, 9 patients (SF = 22.9%, GR = 60.0%) had a complication (p = 0.01). In the SF group, two patients (5.7%) had reoperations for infection; eight patients (53.3%) in the GR group had reoperations for infection and implant complications (p < 0.001). In the SF group, 23/30 parents (76.6%) noted that the child's life "improved a lot." In the GR group, 3/6 parents (50.0%) noted they were "neutral" about their child's ability to do things, 2/6 (33.3%) were "very dissatisfied." CONCLUSIONS: SF treatment for juvenile patients with CP and scoliosis resulted in fewer complications and unplanned reoperations and better radiographic outcomes compared with GR. Quality of life improvements were also better in the SF group. LEVEL OF EVIDENCE: Level III.
Authors: Daniel J Miller; John Jack M Flynn; Saba Pasha; Burt Yaszay; Stefan Parent; Jahangir Asghar; Mark F Abel; Joshua M Pahys; Amer Samdani; Steven W Hwang; Unni G Narayanan; Paul D Sponseller; Patrick J Cahill Journal: J Pediatr Orthop Date: 2020-03 Impact factor: 2.324
Authors: Steven M Hollenbeck; Burt Yaszay; Paul D Sponseller; Carrie E Bartley; Suken A Shah; Jahangir Asghar; Mark F Abel; Firoz Miyanji; Peter O Newton Journal: Spine Deform Date: 2019-05