Autofusion in the Immature Spine Treated With Growing Rods

Cahill, Patrick J.; Marvil, Sean C.; Cuddihy, Laury; Schutt, Corey; Idema, Jocelyn; Clements, David H.; Antonacci, M. Darryl; Asghar, Jahangir; Samdani, Amer F.; Betz, Randal R.

doi:10.1097/brs.0b013e3181e21b50

Cited by 172 publications

(117 citation statements)

References 29 publications

Supporting

Mentioning

106

Contrasting

Unclassified

Order By: Relevance

“…45,46 Autofusion of the spine has been also described after repeated lengthenings. 47 Ultimately, the utility of lengthening may be minimal after the sixth or seventh lengthening procedure, limiting the potential spinal growth to 4 to 5 years after initial surgery.…”

Section: Complications Of Distraction-based Implantsmentioning

confidence: 99%

Early-Onset Scoliosis: A Review of History, Current Treatment, and Future Directions

et al. 2016

View full text Add to dashboard Cite

Early-onset scoliosis (EOS) is defined as curvature of the spine in children >10° with onset before age 10 years. Young children with EOS are at risk for impaired pulmonary function because of the high risk of progressive spinal deformity and thoracic constraints during a critical time of lung development. The treatment of EOS is very challenging because the population is inhomogeneous, often medically complex, and often needs multiple surgeries. In the past, early spinal fusion was performed in children with severe progressive EOS, which corrected scoliosis but limited spine and thoracic growth and resulted in poor pulmonary outcomes. The current goal in treatment of EOS is to maximize growth of the spine and thorax by controlling the spinal deformity, with the aim of promoting normal lung development and pulmonary function. Bracing and casting may improve on the natural history of progression of spinal deformity and are often used to delay surgical intervention or in some cases obviate surgery. Recent advances in surgical implants and techniques have led to the development of growth-friendly implants, which have replaced early spine fusion as the surgical treatment of choice. Treatment with growth-friendly implants usually requires multiple surgeries and is associated with frequent complications. However, growth-friendly spine surgery has been shown to correct spinal deformity while allowing growth of the spine and subsequently lung growth.

show abstract

Section: Complications Of Distraction-based Implantsmentioning

confidence: 99%

Early-Onset Scoliosis: A Review of History, Current Treatment, and Future Directions

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Another complication frequently described is spine autofusion because of the proximity of the growing rod [4]. The consequence is an increasing rigidity of the spine deformity, preventing further rod lengthening and obliging to perform spine arthrodesis in relatively young patients [36].…”

Section: Discussionmentioning

confidence: 99%

“…Several techniques of rodding without fusion have been described (single growing rod, dual growing rods, hybrid growing rod with rib anchors proximally and spine anchors distally, Vertical Expandable Prosthetic Titanium Rib implant) [5,36], but usually with a high complication rate [15]. Implant failure, infection, and unintended autofusion are the most common complications [4,37] and are influenced by the number of lengthening procedures [2]. Most authors recommend concomitant brace treatment to decrease the risk of implant failure [3,16,23,34].…”

Section: Introductionmentioning

confidence: 99%

H3S2 (3 hooks, 2 screws) construct: a simple growing rod technique for early onset scoliosis

Miladi¹,

Journe²,

Mousny

2012

Eur Spine J

View full text Add to dashboard Cite

Purpose The purpose of this study was to review the preliminary results of an original fusionless method of treatment for progressive scoliosis in young children. Methods This study retrospectively reviewed the clinical records and radiographs of 23 children with progressive scoliosis who failed to respond to conservative treatment and underwent fusionless surgery using a single solid growing rod construct. All of them were ambulatory and had a followup of minimum 2 years. Sixteen patients were treated by consecutive distraction of a single intramuscular rod, and seven patients with rodding and anterior apical convex fusion. The etiology of the scoliosis included 11 idiopathic, 6 syndromic, 4 congenital, and 2 neurofibromatosis. At initial surgery, the average age was 9.3 ± 2.8 years, with a mean Cobb angle of 68°± 32°. Six patients underwent progressive scoliosis correction in a Stagnara cast prior to surgery, and one patient with an external halo-pelvic Ilizarov device. Results Fusionless single rodding allowed to maintain scoliosis correction in all patients. At an average of 3.5 ± 0.9 years after initial surgery, the 23 patients showed a correction of 57 % in the magnitude of the original curvature. Trunk height increase was documented in all patients and ranged from 1.5 to 11.9 cm. Rod failure was found in three patients and two patients had hardware infection. Only four cases of proximal junctional kyphosis were found at last follow-up. Conclusions Preliminary results from these series of patients show that the presented fusionless single growing rod technique allows to maintain correction of progressive early onset scoliosis while permitting spinal growth, with low complication rate. With this technique, lengthening procedures are used only once in every 10 months and patients are more comfortable as no brace is needed in most cases. This technique does not require any specific spine device. The procedure is simple and efficacious as long as some guidelines are respected.

show abstract

“…Эффективный «рост» импланта составляет около 5 лет, в связи с чем имплант может быть применен у пациентов от 5 лет, а при достижении 10-летнего возраста этим детям уже может быть выполнен спондило-дез [24,25]. На сегодняшний день применяются две системы раздвижных спинальных имплантов: VEPTR и позвоночная система с использованием крюков и транспедикулярных винтов.…”

Section: лечениеunclassified

Scoliosis in patients with arthrogryposis: a literature review

Agranovich

Евгеньевна²,

Комолкин

et al. 2017

Pediatr Traum Orthop Reconstr Surg

View full text Add to dashboard Cite

2 ФГБОУ ВО «Санкт-Петербургский государственный педиатрический медицинский университет» Минздрава России, Санкт-Петербург Сколиоз у пациентов с артрогрипозом встречается в 2,5-69 % случаев и часто характеризуется быстро про-грессирующим течением, а также ригидностью. По локализации наиболее часто отмечаются деформации груд-ного и грудопоясничного отделов позвоночника, при этом возможно поражение одного либо обоих отделов. Часто сколиоз грудопоясничного отдела позвоночника сочетается с контрактурами в тазобедренных суставах и с перекосом таза. Сколиоз у детей с артрогрипозом, в отличие от аномалий конечностей, как правило, редко диагностируется при рождении, чаще в возрасте 5 лет, что может объясняться периодом быстрого роста по-звоночника. Плохими прогностическими признаками, обусловливающими быстрое развитие сколиоза, служат: прогрессирование в раннем возрасте, паралитический характер деформации, а также наличие перекоса таза. Цель лечения деформаций позвоночника у больных с артрогрипозом -создание предпосылок для нормаль-ного роста и развития грудной клетки, а также восстановление баланса туловища и оси позвоночника. Основ-ными методами лечения данной патологии при артрогрипозе являются: гипсовая коррекция, корсетирование, использование спинальных конструкций, позволяющих осуществлять коррекцию деформаций позвоночника и грудной клетки в процессе роста, а также выполнение спондилодеза. В статье анализируются современные подходы к лечению сколиоза у пациентов с артрогрипозом.Ключевые слова: артрогрипоз, сколиоз, корсетирование, оперативное лечение. The reported incidence of scoliosis in patients with arthrogryposis varies greatly between 2,5% and 69%. Curves can progress quickly. The most typical localizations of scoliosis are the thoracic and the thoracolumbar parts of the spine. In some cases, thoracolumbar scoliosis is combined with contractures in the hip and pelvis oblique. Scoliosis in children with arthrogryposis, as opposed to limb abnormalities, is generally rarely diagnosed at birth. The diagnosis is often established at the age of 5 years and can be explained by a period of rapid spine growth. The poor prognostic signs that determine the rapid development of scoliosis include progression at an early age, paralytic deformity, and pelvis oblique. Treatment options include spine casting, bracing, expandable implant surgery, and spinal fusion. The treatment goal is to allow optimal growth and development of the chest and a well-balanced spine. This article analyzes the modern approach to treatment scoliosis in patients with arthrogryposis. SCOLIOSIS IN PATIENTS WITH ARTHROGRYPOSIS: A LITERATURE REVIEW

show abstract

Autofusion in the Immature Spine Treated With Growing Rods

Cited by 172 publications

References 29 publications

Early-Onset Scoliosis: A Review of History, Current Treatment, and Future Directions

Early-Onset Scoliosis: A Review of History, Current Treatment, and Future Directions

H3S2 (3 hooks, 2 screws) construct: a simple growing rod technique for early onset scoliosis

Scoliosis in patients with arthrogryposis: a literature review

Contact Info

Product

Resources

About