Longitudinal Pilot Analysis of Radiation Exposure During the Course of Growing Rod Treatment for Early-Onset Scoliosis

Pawelek, Jeff; Nomoto, Edward K.; Hennessy, Michael W.; Yaszay, Burt; Akbarnia, Behrooz A.

doi:10.1016/j.jspd.2015.06.004

Cited by 9 publications

(3 citation statements)

References 16 publications

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“…43 A detailed analysis on the radiation exposure of patients with surgically treated EOS was reported by Mundis et al Twenty-four patients with a mean initial radiographic evaluation age of 4 years were followed up for 8.5 years (range: 2.2-19.4 years) and estimated calculations revealed that this population was exposed to 3.4 times more ionizing radiation when compared to the estimated background radiation for general population (2.4 mSv/year). 44 The greatest exposure was before index surgery and during the first postoperative year (22.41 and 10.78 mSv, respectively). As would be expected, patients who underwent revision surgery had a higher exposure, 1.7 times of non-revision patients (p<0.05).…”

Section: Radiation Exposurementioning

confidence: 98%

The Hidden Cost of Growth-Friendly Treatment for Early Onset Scoliosis

Çetik¹,

Yazıcı²

2022

Journal of the Pediatric Orthopaedic Society of North America

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Surgical treatment of early onset scoliosis (EOS) presents unique challenges because of the long period of treatment and multiple surgical interventions. Current surgical techniques are successful in terms of deformity correction, but by looking at a wider perspective, one can see that there is much more to EOS than the radiographic deformity.Growth-friendly treatment with growing rods have the potential to result in a stiff thoracic cage, and treatment can result in significant deteriorations in the child and parents' psychosocial status not only during the treatment period, but even after the surgical treatment is over. The long-term effect of metal ion release and higher radiation exposure of patients with EOS is also an important consideration over the lifetime of the patient.The purpose of this review is to emphasize that EOS is not solely a musculoskeletal disorder but more of a systemic one. Surgical treatment may bring lifelong impacts on the patient's health, some being iatrogenic and others more of a disease-related nature. The non-spine outcomes of EOS treatment should not be overlooked. Key Concepts• Early onset scoliosis (EOS) is a systemic disorder.• Growth-friendly treatments are preferred to prevent cardiopulmonary disease; however, the positive effects on pulmonary development may be less than expected, and repetitive surgical interventions may result in a stiff thoracic cage.• Surgical stress brings a psychosocial burden on the patients which may persist into adulthood.• Persistently elevated levels of metal ions is a serious concern, with unclear long-term effects.• Increased radiation exposure in patients with EOS is still an issue despite the use of new techniques.

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Section: Radiation Exposurementioning

confidence: 98%

The Hidden Cost of Growth-Friendly Treatment for Early Onset Scoliosis

Çetik¹,

Yazıcı²

2022

Journal of the Pediatric Orthopaedic Society of North America

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“…This will reduce the cumulative radiation exposure for patients, which has been a welldescribed problem for children being treated for EOS. [7][8][9] Survey responses indicated that many surgeons who do not currently use ultrasonography are desiring to transition to this imaging modality for routine monitoring of MCGR expansion.…”

Section: Survey Of Expertsmentioning

confidence: 99%

Optimizing Expansion Clinic for Patients With Magnetic Controlled Growth Rods

Garg¹,

Kim²,

Gupta³

2022

J Am Acad Orthop Surg

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In 2017, members of the Pediatric Spine Study Group reported that 80% of new growth-friendly implants inserted were magnetically controlled growing rods (MCGRs). MCGRs are usually expanded more often than every 6 months, as was general practice with traditional growth rods. The growing volume of expansion visits is managed variably at different centers. Although there is existing research comparing MCGRs with traditional systems for efficacy and complications, there is limited literature regarding how expansion clinics are managed. This article reviews current practices such as scheduling, expansion verification, billing, and other key parameters for running expansion clinics.

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“…8,9,10,11 The management of infantile scoliosis requires the frequent use of radiography. 6,7 In order to lower the dosage of radiation, some have developed low dose protocols, specific radiographic sequences, improved technology and even omit radiographs during visits. 12,13,14,15 Yet there is risk when omitting radiographs; some surgeons may find the quality of casting difficult to assess and the potential of time lost in a poorly molded cast.…”

Section: Key Conceptsmentioning

confidence: 99%