Growth-Friendly Implants With Rib Clawing Hooks as Proximal Anchors in Early-Onset Scoliosis

Abstract

Study Design: Retrospective study. Objectives: This study retrospectively evaluates the outcome of the surgical treatment of early-onset scoliosis with proximal clawing rib fixation in hybrid growing-rod constructs. The study examines spinal deformity correction with spinal growth maintenance, and the complications associated with this technique. Method: A hybrid rib construct surgery with serial lengthening was utilized for the treatment of 71 patients. Mean age at surgery was 66.6 months and mean time for follow-up was 43.9 months. Results: The coronal Cobb angle in patients fell from 63.1° preoperatively to 51.6° at the last follow-up, with a correction of 16.8%. The sagittal Cobb angle fell from 66.7° preoperatively to 38° at the last follow-up, with a correction of 42.6%. Coronal balance fell from 22.8° preoperatively to 22.3°, and sagittal balance fell from 35.4 mm preoperatively to 24.39 mm. T1-S1 spine height increased from 248.7 mm preoperatively to 282.4 mm, with a mean change of 1.13 cm per year. No neurological complications were detected. Conclusion: Surgical management for early-onset scoliosis using proximal clawing rib fixation technique is a good choice in terms of safety, ease of placing the proximal anchors, ability to use more than one form of instrumentation, and a lower complication rate.

Early onset scoliosis and current treatment methods

“…These findings may advocate the use of proximal rib hook anchors over the use of spinal-based screws in patients with EOS. 29 3.2.2. VEPTR (vertical expandable prosthetic titanium rib) This is a costal expansion implant made of titanium alloy with costal or hybrid anchors, initially made for thorax and spine deformity children with thoracic insufficiency syndrome (TIS).…”

Do Rib-Based Anchors Impair Chest Wall Motion in Early Onset Scoliosis (EOS)?

“…Surgeons have various fixation options that can be broken up into either spine-based or rib-based anchor points. Biomechanical studies exist reporting on fixation strength for various proximal anchor constructs, but a large majority of the studies evaluate deformity correction percentage and complication rate which comprises mostly infections or proximal anchor failure [12][13][14][15][16][17][18].…”