Treatment of early-onset scoliosis with growing rods in patients with neurofibromatosis-1

Carbone, M.; Vittoria, Francesca; Sal, Alice Del

doi:10.1097/bpb.0000000000000627

Cited by 8 publications

(8 citation statements)

References 25 publications

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“…Recent studies on GRs for EOS patients with NF1 reported coronal correction ranging from 38.6% to 51%. 14,15,20 We corrected the coronal plane at initial surgery and it was maintained throughout the lengthening program, as described previously by Cheung et al 13 We noticed that once instrumented, most curves were mildly progressive and thus required distraction infrequently. For the sagittal plane, instrumentation being in place for several years induces posterior spine epiphysiodesis, 21,22 which may lead to progressive kyphosis correction over time.…”

Section: Discussionmentioning

confidence: 99%

“…Carbone et al reported a 1-year distraction interval in their cohort of NF1 patients. 14 Also, kyphotic forms do not require numerous distractions since posterior autofusion will help correct kyphosis progressively. Another reason for the long distraction interval used in this cohort was that the risk of wound infection is minimized by reducing the frequency of distraction.…”

Section: Discussionmentioning

confidence: 99%

“…Another reason for the long distraction interval used in this cohort was that the risk of wound infection is minimized by reducing the frequency of distraction. 14 Single GRs were implanted initially because we feared that dual GRs would cause more autofusion. Cahill et al 21 suggested that local disturbance of perispinal structures by GRs might cause spontaneous autofusion.…”

Section: Discussionmentioning

confidence: 99%

“…12,13 However, few studies have evaluated the outcomes of GRs in EOS patients with NF1. [14][15][16] The primary objective of this study was to analyze the outcomes of GRs in EOS patients with NF1.…”

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confidence: 99%

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Outcomes of growing rods in a series of early-onset scoliosis patients with neurofibromatosis type 1

Bouthors¹,

Dukan²,

Glorion³

et al. 2020

Journal of Neurosurgery: Spine

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OBJECTIVEEarly-onset scoliosis (EOS) is not uncommon in patients with neurofibromatosis type 1 (NF1). Despite conservative treatment, spinal deformities progress and require early surgical intervention. To avoid potential interference with chest and trunk growth, growing rods (GRs) have been used effectively in EOS of various etiologies. In this study the authors sought to analyze the outcomes of GRs in EOS patients with NF1.METHODSThis was a retrospective single-center cohort study that included consecutive EOS patients with NF1 who were treated with GRs and were followed up for a minimum of 2 years. Clinical and radiological analyses were performed preoperatively and until the last follow-up.RESULTSFrom to 2008 to 2017, 18 patients (6 male, 12 female) underwent GR surgery (14 single GRs, 4 dual GRs) at a mean age of 8 ± 2.1 years. Mean follow-up was 5 ± 2.4 years. Fifty-five lengthenings were performed at a mean rate of 3 lengthenings per patient (range 0–7). Ten of 14 single GRs (71%) were converted into dual GRs during treatment. No patient underwent definitive posterior spinal fusion (PSF) at GR treatment completion. The mean initial and last follow-up major curves were 57° and 36°, respectively (p < 0.001, 37% correction). The average T1–S1 increase was 13 mm/yr. Six of 9 hyperkyphotic patients had normal kyphosis at last follow-up. There were 26 complications involving 13 patients (72%), with 1 patient who required unplanned revision. The primary complications were instrumentation related, consisting of 17 proximal hook dislodgments, 6 distal pedicle screw pullouts, and 2 rod fractures. Only 1 patient experienced a mechanical complication after dual GR implantation. There were no wound infections.CONCLUSIONSThe GR technique provided satisfactory spinal deformity control in EOS patients with NF1 while allowing substantial spinal growth. Adequately contoured dual GRs with proximal hooks placed in nondystrophic regions should be used to minimize implant-related complications. Surgeons should not attempt to correct kyphosis at GR implantation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Outcomes of growing rods in a series of early-onset scoliosis patients with neurofibromatosis type 1

Bouthors¹,

Dukan²,

Glorion³

et al. 2020

Journal of Neurosurgery: Spine

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“…Lengthening rods may either be magnetically controlled or motorized or conventionally expanded by minor repeated surgical procedures. Regardless of the choice of construct, several studies have demonstrated good deformity control, especially in syndromic, neuromuscular and/or congenital disease [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Smaller Intervertebral Disc Volume and More Disc Degeneration after Spinal Distraction in Scoliotic Children

Lippross¹,

Girmond²,

Lüders³

et al. 2021

JCM

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In recent decades, magnetically controlled growing rods (MCGR) were established to treat progressive early-onset scoliosis. The aim of this investigation was to assess the effect of long-term MCGR with continuous distraction on intervertebral discs in scoliotic children. Magnetic resonance imaging (MRI) of 33 children with spinal muscular atrophy was analyzed by grading intervertebral disc degeneration (IDD) and measuring intervertebral disc volume. Cohort I (n = 17) were children who had continuous spinal distraction with MCGRs for 5.1 years and MRI before (av. age 8.1) and after (av. age 13.4) MCGR treatment. Cohort II (n = 16, av. age 13.7) were patients without prior surgical treatment. Lumbar intervertebral disc volume of cohort I did not change during 5.1 years of MCGR treatment, whereas disc volumes were significantly larger in age- and disease-matched children without prior treatment (cohort II). Cohort I showed more IDD after MCGR treatment in comparison to early MRI studies of the same patients and children without surgical treatment. MRI data showed a volume reduction and disc degeneration of lower thoracic and lumbar intervertebral discs in scoliotic children after continuous spinal distraction with MCGRs. These effects were confirmed in the same subjects before and after treatment as well as in surgically untreated controls.

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Neurofibromatosis

Jain

Crawford

2022

The Growing Spine

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Treatment of early-onset scoliosis with growing rods in patients with neurofibromatosis-1

Cited by 8 publications

References 25 publications

Outcomes of growing rods in a series of early-onset scoliosis patients with neurofibromatosis type 1

Outcomes of growing rods in a series of early-onset scoliosis patients with neurofibromatosis type 1

Smaller Intervertebral Disc Volume and More Disc Degeneration after Spinal Distraction in Scoliotic Children

Neurofibromatosis

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