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Ultrasonographic assessment of magnetic growing rods overestimates the lengthening of the thoracic spine compared to radiographs in early-onset scoliotic patients

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Abstract

Purpose

Magnetic growing rods (MGRs) are one of the most common procedures to treat early-onset scoliosis (EOS). Radiographic examinations (X-ray) or ultrasonographic (US) assessments are used to evaluate the lengthening of the rods. X-ray exposes patients to radiation, while the US has not been validated and may be affected by the radiologist’s ability to assess elongation. The research question of the present study is to compare the difference between US and X-ray growth assessments in EOS patients treated with MGRs.

Methods

The study enrolled 65 patients consecutively from July 2011 to July 2022. Noninvasive lengthening was performed every four months, and X-ray follow-up was performed at different intervals. An experienced radiologist assessed the mean US rod elongation per session. The mean elongation/session of T2-T12 and T2-S1 was calculated, and the results were compared using an independent t-test.

Results

The mean age at operation was 8.8 ± 2 years, and the mean follow-up was four ± two years. The average rod elongation assessed by the US was 3.1 ± 0.1 mm. The average rod elongation evaluated by X-ray was 1.2 ± 2.9 mm (T2-T12) and 1.8 ± 1.9 mm (T2-S1). The difference between the values measured by US and X-ray was statistically significant in the T2-T12 group (p < 0.05) and not significant in the T2-S1 group (p = 0.34).

Conclusions

This is the most extensive single-center study comparing US and X-ray data for MGRs in EOS patients. US overestimates thoracic spine elongation compared to X-ray. US elongation analysis could be appropriate in long thoracolumbar curves.

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Acknowledgements

We would thank Dr. Gian Mario Sangiovanni, Sapienza University of Rome, for the statistical advice.

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Authors and Affiliations

  1. Orthopedic Unit, Department of Surgery, Bambino Gesù Children’s Hospital, Rome, Italy

    Leonardo Oggiano, Sergio De Salvatore, Sergio Sessa, Cloe Curri & Pier Francesco Costici

  2. Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Fondazione Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Roma, Italy

    Sergio De Salvatore & Laura Ruzzini

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  1. Leonardo Oggiano
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Contributions

Conceptualization, S.D.S. and O.L.; data curation, S.D.S., S.S., and L.R.; formal analysis, S.D.S.; methodology, S.D.S., C.C.; software S.D.S.; supervision, L.O. and P.F.C.; validation, P.F.C.; visualization, L.O.; writing—original draft, S.D.S.; writing—review and editing, S.D.S. and L.O. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Sergio De Salvatore.

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The need to obtain informed consent was waived based on the retrospective design and anonymization of patient identifiers. All methods were performed in accordance with the relevant guidelines and regulations.

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Oggiano, L., De Salvatore, S., Sessa, S. et al. Ultrasonographic assessment of magnetic growing rods overestimates the lengthening of the thoracic spine compared to radiographs in early-onset scoliotic patients. International Orthopaedics (SICOT) (2023). https://doi.org/10.1007/s00264-023-06027-x

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