Management of Early Onset Scoliosis using Growing Spine Profiler (GSP)

Abstract

Introduction Achieving adequate surgery for early onset scoliosis (EOS) is difficult because of many challenges including the need to correct the deformity, the need to allow adequate spine growth, to allow adequate lung development, and the need to minimize complications. GSP system was found to solve these troubles with minimal complications in comparison with other techniques. This is a preliminary analysis and report about the efficacy and safety of GSP system in treating patients with early onset scoliosis Patients and Methods This is a combined prospective and retrospective study of 15 patients (9 females and 6 males) with EOS. The age ranged between 3.5 and 7 years old. All patients were treated with GSP system in our hospital and were prospectively followed for a minimum of 1 year. The following parameters were measured both preoperatively and posteoperatively and at each follow up visit. 1- Cobb's angle correction. 2-T1-S1 height. 3-apical vertebral translation (AVT). 4-space available for the lung (SAL) ratio. 5-shoulder and pelvic balance. Also all surgical details were recorded including, single or dual rod technique used, operative time, blood loss, and intraoperative complications. Post-operative follow up schedule at 8 weeks and every 6 months for serial lengthening and assessment of the previous parameters after each lengthening. Any complication during follow up is recorded. This group was compared with a similar historical cohort treated earlier by Growing Rods. Results Surgical details -blood loss 90ml (80–300). -operative time 1.5 hours. -number of rods (3 cases single rod and 7 cases dual rods). -number of lengthening procedures 0–4 times. -number of additional procedures 4. Follow up - Mean follow up 4months (3–18) months. - Cobb's angle corrected from (90.4) to (44). -AVT improved from 54mm to 34mm -T1-S1 height improved from 210mm to 305mm. -SAL ratio improved from 89% to 84%. Intraoperative complications. -pleural injury 5 cases. -others 0. Postoperative complications -Screw pull-out 2 cases. -hook dislodgement 0. -neurological injury 0. -infection 2 cases (superficial wound infection). -prominent metal 1 case. -metal failure 2 cases (single rod group) Conclusion GSP seems to be a good and economic option for management of EOS with proper patient selection and proper surgical technique

Autofusion in growing rod surgery for early onset scoliosis; what do we know so far?

“…In our centre, we operated a fair number of children with EOS using growing rods starting in 2009, with favourable short-term results [ 47 , 48 ]. Among these, 11 patients underwent definitive fusion.…”