The Cure of Experimental Scoliosis by Directed Growth Control

Nachlas, I W; Borden, James

doi:10.2106/00004623-195133010-00002

Cited by 88 publications

(28 citation statements)

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“…Nachlas and Borden created spinal deformity in dogs by placing staples into the vertebral bodies and then corrected the deformity by stapling the opposite side. 5,6 Newton et al placed an anterolateral flexible cable tether over a single motion segment in a bovine spine and found a significant creation of scoliosis as well as a modest increased kyphosis in the tethered segments compared with internal controls. 7 Braun et al 4 used a left-sided rigid posterior construct from T5 to L1 in combination with convex rib resection and concave rib tethering in an immature goat spine to yield an average of 18°of scoliosis and 4°of lordosis created over 15 weeks of growth.…”

Section: Discussionmentioning

confidence: 99%

Multilevel Spinal Growth Modulation With an Anterolateral Flexible Tether in an Immature Bovine Model

Newton

Faro²,

Farnsworth³

et al. 2005

Spine

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Section: Discussionmentioning

confidence: 99%

Multilevel Spinal Growth Modulation With an Anterolateral Flexible Tether in an Immature Bovine Model

Newton

Faro²,

Farnsworth³

et al. 2005

Spine

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“…The application of intervertebral staples to correct a spinal curve is not a new idea, and has been considered since the early Nachlas and Borden [13] investigation in 1951. The placement of staples into a growing spine was later attempted, but was abandoned as the staples failed to prevent progression [14].…”

Section: Discussionmentioning

confidence: 99%

The modulation of spinal growth with nitinol intervertebral stapling in an established swine model

Carreau

Farnsworth

Glaser³

et al. 2012

Journal of Children's Orthopaedics

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Purpose Anterior spinal stapling for the treatment of adolescent idiopathic scoliosis has been shown to slow progression in small curves; however, its role in larger curves remains unclear. The purpose of this study was to evaluate the effectiveness of nitinol staples to modulate spinal growth by evaluating the two-dimensional and threedimensional morphological and histological effects of this method in a well-established porcine model. Methods Three immature Yucatan miniature pigs underwent intervertebral stapling. Two staples spanned each of three consecutive mid-thoracic discs and epiphyses. Monthly radiographs were obtained. Computed tomography (CT) was conducted at harvest after 6 months of growth. Measurements of wedging and height for each disc and vertebral body were conducted. Micro CT was used to compare physeal closure between stapled and non-stapled levels. Histology of the growth plate also compared the hypertrophic zone thickness for control and stapled vertebrae.Results After 6 months of stapled growth, the average coronal Cobb angle of the stapled segments increased by 7.7 ± 2.0°and kyphosis increased by 3.3 ± 0.6°compared to preoperative curves. Increased vertebral wedging and decreased disc height (p \ 0.001) were noted in stapled regions. Overall, 26 ± 23 % of each growth plate was closed in the stapled segments, with 6 ± 8 % closure in the unstapled levels. No difference was observed regarding the hypertrophic zone height when comparing instrumented to uninstrumented levels, nor was a difference recognized when comparing right versus left regions within stapled levels alone. Conclusions Six months of nitinol intervertebral stapling created a mild coronal and sagittal deformity associated with reduced vertebral and disc height, and increased coronal vertebral and sagittal disc wedging.

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“…The first study on spine stapling was published in 1951 by Nachlas and Borden, 67 who used a canine model to produce evidence of successful spinal growth modulation. This study was followed by another study with disappointing results in 3 human patients by Smith and colleagues 68 in 1954; all 3 patients progressed despite stapling.…”

Section: Compression-based Systems Anterolateral Staple/tethermentioning

confidence: 99%