The effect of growing rod lengthening technique on the sagittal spinal and the spinopelvic parameters

Atıcı, Yunus; Akman, Yunus Emre; Erdoğan, Sinan; Sarı, Seçkin; Yavuz, Umut; Çarkçı, Engin; Kaygusuz, Mehmet Akif

doi:10.1007/s00586-014-3422-8

Cited by 28 publications

(10 citation statements)

References 17 publications

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“…It has been reported that there is a small increase in PI values during growth and during the growing-rod lengthenings [8,9,11,17]. Similar to the result found in our study, Atici et al [19] found a decrease in the PI during lengthening, which was not statistically significant. In our study, the pelvic parameters PT and SS showed no significant change during the treatment, in agreement with the literature.…”

Section: Discussionsupporting

confidence: 86%

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Effect of growing rod on sagittal and spinopelvic parameters in early-onset scoliosis patients

Sariyilmaz

Akgül

Özkunt

et al. 2016

Journal of Pediatric Orthopaedics B

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Growing rod is a commonly used surgery for early-onset scoliosis (EOS). However, the effect of growing-rod lengthening on the spinopelvic alignment is unclear. In this study, 21 EOS patients treated by growing rod were evaluated retrospectively and thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI) , sacral slope (SS), pelvic tilt (PT), and sagittal vertical axis (SVA) were measured. Preoperatively, the mean TK, LL, PI, PT, SS, and SVA were 27.4°, 35.2°, 43.8°, 7.5°, 33.8°, and 47.7 mm respectively. After the last lengthening, TK, LL, PI, PT, SS, and SVA were 28.3°, 28.06°, 41.4°, 7°, 5.2°, and 42.6 mm, respectively. The sagittal plane parameters in our EOS patients were not significantly altered during the lengthening period.

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Section: Discussionsupporting

confidence: 86%

“…In a previous study, Atici et al [19] evaluated 23 EOS patients who underwent growing-rod surgery. They found a significant improvement in the global TK angle on comparing the preoperative, the early postoperative, and the last follow-up parameters, and no significant improvement in the spinopelvic parameters.…”

Section: Discussionmentioning

confidence: 99%

Effect of growing rod on sagittal and spinopelvic parameters in early-onset scoliosis patients

Sariyilmaz

Akgül

Özkunt

et al. 2016

Journal of Pediatric Orthopaedics B

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“…The pooled average SSI rate was calculated to be 1.6% (median, 2.8%; range, 0.2%–18.3%) based on 64 cohorts comprising a total of 212,639 patients. Patients who underwent instrumented spinal fusion procedures were evaluated for SSIs in 35 identified studies [6,12,25,28,35,37,39,48,50,61,67,74,77,78,84,85,90,93,97,98,101,112,121,122,126,127,132,134,135,137,148,154,156,160,174]. The pooled average SSI rate was calculated to be 3.8% (median, 4.2%; range, 0.4%–20%) based on 39 cohorts with a total of 28,628 patients.…”

Section: Resultsmentioning

confidence: 99%

Burden of Surgical Site Infections Associated with Select Spine Operations and Involvement ofStaphylococcus aureus

Patel¹,

Khoury²,

Girgenti

et al. 2017

Surgical Infections

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Background: Spine operations may be indicated for treatment of diseases including vertebral injuries, degenerative spinal conditions, disk disease, spinal misalignments, or malformations. Surgical site infection (SSI) is a clinically important complication of spine surgery. Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus (MRSA), is a leading cause of post-spinal SSIs.Methods: PubMed and applicable infectious disease conference proceedings were searched to identify relevant published studies. Overall, 343 full-text publications were screened for epidemiologic, mortality, health care resource utilization, and cost data on SSIs associated with specified spine operations.Results: Surgical site infection rates were identified in 161 studies from North America, Europe, and Asia. Pooled average SSI and S. aureus SSI rates for spine surgery were 1.9% (median, 3.3%; range, 0.1%–22.6%) and 1.0% (median, 2.0%; range, 0.02%–10.0%). Pooled average contribution of S. aureus infections to spinal SSIs was 49.3% (median, 50.0%; range, 16.7%–100%). Pooled average proportion of S. aureus SSIs attributable to MRSA was 37.9% (median, 42.5%; range, 0%–100%). Instrumented spinal fusion had the highest pooled average SSI rate (3.8%), followed by spinal decompression (1.8%) and spinal fusion (1.6%). The SSI-related mortality rate among spine surgical patients ranged from 1.1%–2.3% (three studies). All studies comparing SSI and control cohorts reported longer hospital stays for patients with SSIs. Pooled average SSI-associated re-admission rate occurring within 30 d from discharge ranged from 20% to 100% (four studies). Pooled average SSI-related re-operation rate was 67.1% (median, 100%; range, 33.5%–100%). According to two studies reporting direct costs, spine surgical patients incur approximately double the health care costs when they develop an SSI.Conclusions: Available published studies demonstrate a clinically important burden of SSIs related to spine operations and the substantial contribution of S. aureus (including MRSA). Preventive strategies aimed specifically at S. aureus SSIs could reduce health care costs and improve patient outcomes for spine operations.

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“…These results demonstrate that repeated distraction forces associated with rib anchors in the VEPTR construct may be more kyphogenic, which could pose a risk of kyphosis gain with the VEPTR during the lengthening period. In previous studies, 3,6,18,19 it was revealed that GRI can effectively correct hyperkyphotic EOS, with the sagittal pro-file successfully restored to a normal range. The change in sagittal plane alignment reveals that GRI has a strong tendency to decrease TK in patients with a preoperative hyperkyphotic sagittal modifier.…”

Section: Discussionmentioning

confidence: 99%

Evolution of the postoperative sagittal spinal profile in early-onset scoliosis: is there a difference between rib-based and spine-based growth-friendly instrumentation?

Chen¹,

Song²,

Qiu³

et al. 2017

Journal of Neurosurgery: Pediatrics

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OBJECTIVEAlthough the vertical expandable prosthetic titanium rib (VEPTR) and growing rod instrumentation (GRI) encourage spinal growth via regular lengthening, they can create different results because of their different fixation patterns and mechanisms in correcting scoliosis. Previous studies have focused comparisons on coronal plane deformity with minimal attention to the sagittal profile. In this retrospective study, the authors aimed to compare the evolution of the sagittal spinal profile in early-onset scoliosis (EOS) treated with VEPTR versus GRI.METHODSThe data for 11 patients with VEPTR and 22 with GRI were reviewed. All patients had more than 2 years’ follow-up with more than 2 lengthening procedures. Radiographic measurements were performed before and after the index surgery and at the latest follow-up. The complications in both groups were recorded.RESULTSPatients in both groups had similar diagnoses, age at the index surgery, and number of lengthening procedures. The changes in the major coronal Cobb angle and T1–S1 spinal height were not significantly different between the 2 groups. Compared with the GRI group, the VEPTR group had less correction in thoracic kyphosis (23% ± 12% vs 44% ± 16%, p < 0.001) after the index surgery and experienced a greater correction loss in thoracic kyphosis (46% ± 18% vs 11% ± 8%, p < 0.001) at the latest follow-up. Although the increase in the proximal junctional angle was not significantly different (VEPTR: 7° ± 4° vs GRI: 8° ± 5°, p = 0.569), the incidence of proximal junctional kyphosis was relatively lower in the VEPTR group (VEPTR: 18.2% vs GRI: 22.7%). No significant changes in the spinopelvic parameters were observed, while the sagittal vertical axis showed a tendency toward a neutral position in both groups. The overall complication rate was higher in the VEPTR group than in the GRI group (72.7% vs 54.5%).CONCLUSIONSThe VEPTR had coronal correction and spinal growth results similar to those with GRI. In the sagittal plane, however, the VEPTR was not comparable to the GRI in controlling thoracic kyphosis. Thus, for hyperkyphotic EOS patients, GRI is recommended over VEPTR.

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The effect of growing rod lengthening technique on the sagittal spinal and the spinopelvic parameters

Cited by 28 publications

References 17 publications

Effect of growing rod on sagittal and spinopelvic parameters in early-onset scoliosis patients

Effect of growing rod on sagittal and spinopelvic parameters in early-onset scoliosis patients

Burden of Surgical Site Infections Associated with Select Spine Operations and Involvement ofStaphylococcus aureus

Evolution of the postoperative sagittal spinal profile in early-onset scoliosis: is there a difference between rib-based and spine-based growth-friendly instrumentation?

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