Vertebral column growth in children with early onset scoliosis treated with magnetically controlled growing rods – Effects of distraction on vertebral and disc morphology

Stuecker, Sebastian; Mladenov, Kiril; Kunkel, Philip; Hagemann, Christian; Freiwald, Eric; Stuecker, Ralf

doi:10.1016/j.surge.2021.07.007

Cited by 6 publications

(11 citation statements)

References 15 publications

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“…Deprivation from axial loads (stress‐shielding) may lead to an extra gain in height at the expense of impaired vertebral growth in depth and width 38 . Hasler et al did a similar study and found the vertebrae getting slender under VEPTR distraction 8,39 . Another point, the cuneate ratio AB/CD represented the deformation progression and the ratio gradually reaches 1 in our study (Figure 11b).…”

Section: Discussionsupporting

confidence: 68%

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Orthopedic mechanism analysis of growing rod distraction for early‐onset scoliosis based on 3D morphological parameters

Lu,

Wu,

Zhao

et al. 2023

Journal Orthopaedic Research

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Traditional growing rod provides a corrective moment for deformed segments to straighten the spine, whose clinical efficacy has proven positive and growth‐friendly. However, an insufficient understanding of orthopedic mechanisms can affect the development of clinical strategies. This research attempts to analyze the spine that has undergone four distraction operations, exploring the spinal orthopedic mechanism, including alignment, growth, and morphology. In this study, the spinal morphology curves were illustrated in three human planes to exhibit the changes in spinal alignment. The spinal growth characteristics were measured to discuss the unsynchronized and diminishing growth rate. The spinal deformations were evaluated to indicate asymmetric growth. As a result, the spinal alignment changes indicated the orthopedic process improved, but the re‐unbalance occurred after multiple distractions. Then, unsynchronized growth existed in the superior and inferior segments, and the growth rate over every distraction diminished. Finally, asymmetric growth was indicated as the axial/circumferential growth ratio getting greater and the cuneate level approaching normal. Accordingly, a traditional growing rod is growth‐friendly, but combining the osteotomy fusion of lumbar segments for severe early onset scoliosis may be an excellent choice to solve the insufficient corrective stimulation. Regarding the distraction process, reshaping before the final fusion can fix the balance loss, and a prolonged distraction frequency fits the law of diminishing return. In conclusion, studying orthopedic mechanisms based on morphological measurement can guide clinical strategy optimization.This article is protected by copyright. All rights reserved.

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Section: Discussionsupporting

confidence: 68%

“…38 Hasler et al did a similar study and found the vertebrae getting slender under VEPTR distraction. 8,39 Another point, the cuneate ratio AB/CD represented the deformation progression and the ratio gradually reaches 1 in our study (Figure 11b). It indicated that the orthopedic process could rely on deformation amelioration.…”

Section: Discussionsupporting

confidence: 59%

Orthopedic mechanism analysis of growing rod distraction for early‐onset scoliosis based on 3D morphological parameters

Lu,

Wu,

Zhao

et al. 2023

Journal Orthopaedic Research

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“…Coupled with the effects of gravity, this may result in an uneven weight distribution or loading of the spine and joints. Consequently, according to the Heuter-Volkman principle [ 28 ], this could result in spinal deformities for these children. This may help explain why those children with greater motor impairment (higher GMFCS levels), or spastic and dyskinetic CP, who often have difficulty maintaining or changing position, were more likely to develop scoliosis.…”

Section: Discussionmentioning

confidence: 99%

Incidence and sequence of scoliosis and windswept hip deformity: which comes first in 4148 children with cerebral palsy? A longitudinal cohort study

Casey,

Rosenblad,

Agustsson

et al. 2024

BMC Musculoskelet Disord

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Background The aim was to analyse whether scoliosis or windswept hip deformity (WSH) occurs first for children with cerebral palsy (CP). Methods This longitudinal cohort study using data from 1994 − 2020 (26 years) involved 41,600 measurements of 4148 children (2419 [58.3%] boys) with CP born 1990 − 2018 and registered into the Swedish CP follow-up program. Children were followed from a mean age of 2.8 [SD 1.4] years, until they developed either scoliosis or WSH or were removed at surgery. Results WSH developed first in 16.6% of the children (mean age 8.1 [SD 5.0] years), and scoliosis in 8.1% (mean age 8.1 [SD 4.9] years). The incidence of WSH was higher than scoliosis across all levels I–V of the Gross Motor Function Classification System (GMFCS), both sexes, and for those with dyskinetic (20.0%) or spastic (17.0%) CP. The incidence of scoliosis was highest (19.8%) and developed earliest in children with GMFCS level V (mean age 5.5 [SD 3.5] years), and in children with dyskinetic (17.9%) CP (mean age 7.0 [SD 4.7] years). Conclusions WSH presents earlier than scoliosis in most children with CP. Children with higher GMFCS level or dyskinetic CP are more likely to develop these deformities at a younger age.

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“…Curvatures between 10° and 25° are described as “observational;” those ranging from 25° to 40° usually require a cast or corrective orthoses, 1 and curvatures higher than 40° to 45° are eligible for surgical approach. 5 6…”

Section: Introductionmentioning

confidence: 99%

“…The advancement of surgical techniques resulted in several new approaches proposed to manage idiopathic scoliosis, such as magnetically controlled growth rods 6 and minimally invasive surgeries that seek to increase the quality of life, individualize treatment, and reduce the risks associated with traditional surgery. 8 9 10…”

Section: Introductionmentioning

confidence: 99%

Cirurgia toracoscópica na abordagem da escoliose idiopática: Revisão sistemática de literatura

Aziz,

Blattes

2023

Rev Bras Ortop (Sao Paulo)

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ResumoA escoliose idiopática é caracterizada por um quadro de deformidade tridimensional da coluna vertebral com rotação axial e inclinação lateral com angulação maior que 10° segundo o Método de Cobb. Sua abordagem pode se dar de maneira conservadora ou cirúrgica, a depender do grau de angulação, desenvolvimento osteomuscular e idade da criança ou adolescente acometido, ou ainda, a depender do comprometimento funcional advindo da condição. O objetivo deste estudo foi analisar o impacto da videotoracoscopia na abordagem da escoliose idiopática. Trata-se de uma revisão sistemática de literatura, construída conforme protocolo Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) e registrada no PROSPERO sob número CRD42022351466. A busca por estudos foi realizada entre agosto de 2022 e setembro do mesmo ano, em bancos de dados bibliográficos incluindo MEDLINE, The Cochrane Library e Web of Science. A técnica é uma alternativa minimamente invasiva à toracotomia que apresentou grande evolução nos últimos anos. Destacam-se como principais vantagens a menor perda sanguínea durante procedimento, menor tempo de internação e melhora da estética pós-cirúrgica. Uma das desvantagens citadas pelos autores é a maior complexidade e exigência tecnológica, maior tempo cirúrgico e necessidade de seleção criteriosa dos pacientes, conforme graus de desvio vertebral. O uso de analgésicos e anti-inflamatórios não teve diferença significativa entre os procedimentos tradicionais (toracotomia) ou videotoracoscopia.

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Vertebral column growth in children with early onset scoliosis treated with magnetically controlled growing rods – Effects of distraction on vertebral and disc morphology

Cited by 6 publications

References 15 publications

Orthopedic mechanism analysis of growing rod distraction for early‐onset scoliosis based on 3D morphological parameters

Orthopedic mechanism analysis of growing rod distraction for early‐onset scoliosis based on 3D morphological parameters

Incidence and sequence of scoliosis and windswept hip deformity: which comes first in 4148 children with cerebral palsy? A longitudinal cohort study

Cirurgia toracoscópica na abordagem da escoliose idiopática: Revisão sistemática de literatura

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