Reliability of Rod Lengthening, Thoracic, and Spino-Pelvic Measurements on Biplanar Stereoradiography in Patients Treated With Magnetically Controlled Growing Rods

Obid, Peter; Yiu, Karen; Cheung, Kenneth M.C.; Kwan, Kenny; Ruf, Michael; Cheung, Jason Pui Yin

doi:10.1097/brs.0000000000002671

Cited by 10 publications

(3 citation statements)

References 29 publications

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“…34 A validated predictive model of correction rate using supine flexibility has also been established for thoracic curves. 13,35 Our findings on the predictive ability of flexibility and correction rate largely coincide with the literature. [11][12][13] We have shown that high correction rate and flexibility are significantly predictive of brace success after adjusting for commonly assessed radiological predictors.…”

Section: Discussionsupporting

confidence: 87%

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Supine correction index as a predictor for brace outcome in adolescent idiopathic scoliosis

Wong

Cheung

2022

The Bone & Joint Journal

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Aims The aim of this study was to assess the ability of morphological spinal parameters to predict the outcome of bracing in patients with adolescent idiopathic scoliosis (AIS) and to establish a novel supine correction index (SCI) for guiding bracing treatment. Methods Patients with AIS to be treated by bracing were prospectively recruited between December 2016 and 2018, and were followed until brace removal. In all, 207 patients with a mean age at recruitment of 12.8 years (SD 1.2) were enrolled. Cobb angles, supine flexibility, and the rate of in-brace correction were measured and used to predict curve progression at the end of follow-up. The SCI was defined as the ratio between correction rate and flexibility. Receiver operating characteristic (ROC) curve analysis was carried out to assess the optimal thresholds for flexibility, correction rate, and SCI in predicting a higher risk of progression, defined by a change in Cobb angle of ≥ 5° or the need for surgery. Results The baseline Cobb angles were similar (p = 0.374) in patients whose curves progressed (32.7° (SD 10.7)) and in those whose curves remained stable (31.4° (SD 6.1)). High supine flexibility (odds ratio (OR) 0.947 (95% CI 0.910 to 0.984); p = 0.006) and correction rate (OR 0.926 (95% CI 0.890 to 0.964); p < 0.001) predicted a lower incidence of progression after adjusting for Cobb angle, Risser sign, curve type, menarche status, distal radius and ulna grading, and brace compliance. ROC curve analysis identified a cut-off of 18.1% for flexibility (sensitivity 0.682, specificity 0.704) and a cut-off of 28.8% for correction rate (sensitivity 0.773, specificity 0.691) in predicting a lower risk of curve progression. A SCI of greater than 1.21 predicted a lower risk of progression (OR 0.4 (95% CI 0.251 to 0.955); sensitivity 0.583, specificity 0.591; p = 0.036). Conclusion A higher supine flexibility (18.1%) and correction rate (28.8%), and a SCI of greater than 1.21 predicted a lower risk of progression. These novel parameters can be used as a guide to optimize the outcome of bracing. Cite this article: Bone Joint J 2022;104-B(4):495–503.

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Section: Discussionsupporting

confidence: 87%

“… 34 A validated predictive model of correction rate using supine flexibility has also been established for thoracic curves. 13 , 35 …”

Section: Discussionmentioning

confidence: 99%

Supine correction index as a predictor for brace outcome in adolescent idiopathic scoliosis

Wong

Cheung

2022

The Bone & Joint Journal

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“…Hence, the prevalence of PJK is high with up to 30% in some reports but not all require reoperation (approximately 15%). 28,[41][42][43][44] In general, the proximal levels of T1 or T2 should be avoided if possible as more cranial levels may be needed in the final fusion surgery to address the PJK. Conversion to rib anchors may help prevent these complications and has been well-established in TGR surgery.…”

Section: Anchorsmentioning

confidence: 99%

Current status of the magnetically controlled growing rod in treatment of early-onset scoliosis: What we know after a decade of experience

Cheung

2019

J Orthop Surg (Hong Kong)

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The magnetically controlled growing rod (MCGR) has had approximately 10 years of clinical experience worldwide. Clinical effectiveness to control early-onset scoliosis is consistent even at final surgery. MCGRs have significantly lower relative percentage of infection or wound complications as compared to traditional growing rods. Most common complications include foundation failure and failure of distraction. Contouring of the rod especially at the proximal segment while accommodating for the straight actuator remains a difficult task and its failure may lead to proximal junctional kyphosis. Unique complications of MCGR include clunking, temporary diminishing distraction gains, and metallosis. Temporary reductions in distraction gains are observed as the MCGR lengthens but return to normal baseline distraction gains after rod exchange. Lack of standardization for rod configuration, distraction strategies and decisions of whether to keep the rods in situ, remove without fusion surgery or to perform spinal fusion at skeletal maturity will require further study.

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Magnetically controlled growing rods in early onset scoliosis: radiological results, outcome, and complications in a series of 22 patients

Obid

Yiu

Cheung

et al. 2020

Arch Orthop Trauma Surg

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Reliability of Rod Lengthening, Thoracic, and Spino-Pelvic Measurements on Biplanar Stereoradiography in Patients Treated With Magnetically Controlled Growing Rods

Abstract: 3.

Cited by 10 publications

References 29 publications

Supine correction index as a predictor for brace outcome in adolescent idiopathic scoliosis

Supine correction index as a predictor for brace outcome in adolescent idiopathic scoliosis

Current status of the magnetically controlled growing rod in treatment of early-onset scoliosis: What we know after a decade of experience

Magnetically controlled growing rods in early onset scoliosis: radiological results, outcome, and complications in a series of 22 patients

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