Abhishek Srivastava1, Naveen Pandita2, Anuj Gupta1, Ankur Goswami3, G Vijayraghvan4, Arvind Jayaswal1. 1. Department of Spine Surgery, Max Superspeciality Hospital, Vaishali, Ghaziabad, Uttar Pradesh, India. 2. Department of Spine Surgery, Max Superspeciality Hospital, Vaishali, Ghaziabad, Uttar Pradesh, India. naveenpandita1986@gmail.com. 3. Department of Spine Surgery, Urolife Polyclinic, New Delhi, India. 4. Department of Spine Surgery, MGM Hospital, Chennai, India.
Abstract
OBJECTIVE: Operative treatment of early onset scoliosis (EOS) with Magnetically Controlled Growing Rod (MCGR) in moderate-to-severe curves poses a challenge due to the limited amount of force and length available with the implant. The purpose of this study was to assess the use of the intra-operative internal spine distraction using Harrington Outrigger, before definitive implantation of MCGR, with regard to initial correction, maintenance of correction, truncal balance, and complication rates. PATIENTS AND METHODS: 16 EOS patients treated with the application of MCGR using the intra-operative internal distractor technique were included in the study. More than 50% of cases were congenital scoliosis with multiple vertebral anomalies. All patients were followed up for a minimum of 2 years. Radiological measurement of change in Cobb angle, thoracic kyphosis, lumbar lordosis, T1-S1 length, T1-T12l length, and sagittal balance were done at pre-op, immediate post-op, after 1 year, and 2 years. All the complications were noted and documented. RESULTS: The mean age of the operated patients was 8 ± 1.7 years, range (4-10 years). Mean pre-operative Cobb angle was 70.4 degrees. The mean correction of major Cobb angle was 34.6°. The percentage correction achieved in post-operative Cobb angle was about 51%. Mean change in post-operative thoracic kyphosis was 18.5° (40%). The average gain in immediate post-operative spinal length (T1-S1) and thoracic height (T1-T12) was 46.7 mm (18.3%) and 41 mm (23%), respectively. CONCLUSION: Large and rigid curves in EOS can achieve a significant correction of Cobb angle and coronal imbalance during the index operation, by the use of intra-operative internal distraction at the time of MCGR insertion. LEVEL AND TYPE OF STUDY: Retrospective clinical study, level 4.
OBJECTIVE: Operative treatment of early onset scoliosis (EOS) with Magnetically Controlled Growing Rod (MCGR) in moderate-to-severe curves poses a challenge due to the limited amount of force and length available with the implant. The purpose of this study was to assess the use of the intra-operative internal spine distraction using Harrington Outrigger, before definitive implantation of MCGR, with regard to initial correction, maintenance of correction, truncal balance, and complication rates. PATIENTS AND METHODS: 16 EOS patients treated with the application of MCGR using the intra-operative internal distractor technique were included in the study. More than 50% of cases were congenital scoliosis with multiple vertebral anomalies. All patients were followed up for a minimum of 2 years. Radiological measurement of change in Cobb angle, thoracic kyphosis, lumbar lordosis, T1-S1 length, T1-T12l length, and sagittal balance were done at pre-op, immediate post-op, after 1 year, and 2 years. All the complications were noted and documented. RESULTS: The mean age of the operated patients was 8 ± 1.7 years, range (4-10 years). Mean pre-operative Cobb angle was 70.4 degrees. The mean correction of major Cobb angle was 34.6°. The percentage correction achieved in post-operative Cobb angle was about 51%. Mean change in post-operative thoracic kyphosis was 18.5° (40%). The average gain in immediate post-operative spinal length (T1-S1) and thoracic height (T1-T12) was 46.7 mm (18.3%) and 41 mm (23%), respectively. CONCLUSION: Large and rigid curves in EOS can achieve a significant correction of Cobb angle and coronal imbalance during the index operation, by the use of intra-operative internal distraction at the time of MCGR insertion. LEVEL AND TYPE OF STUDY: Retrospective clinical study, level 4.
Authors: Sebastiaan P J Wijdicks; Isabel N Tromp; Muharrem Yazici; Diederik H R Kempen; René M Castelein; Moyo C Kruyt Journal: Spine J Date: 2018-10-02 Impact factor: 4.166
Authors: Behrooz A Akbarnia; Jeff B Pawelek; Kenneth M C Cheung; Gokhan Demirkiran; Hazem Elsebaie; John B Emans; Charles E Johnston; Gregory M Mundis; Hilali Noordeen; David L Skaggs; Paul D Sponseller; George H Thompson; Burt Yaszay; Muharrem Yazici Journal: Spine Deform Date: 2014-10-27
Authors: Chrishan Thakar; David Christopher Kieser; Mihai Mardare; Shahnawaz Haleem; Jeremy Fairbank; Colin Nnadi Journal: Eur Spine J Date: 2018-04-19 Impact factor: 3.134