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Continued vertebral body growth in patients with juvenile idiopathic scoliosis following vertebral body stapling

  • Case Series
  • Published:
Spine Deformity Aims and scope Submit manuscript

Abstract

Study design

Retrospective case series.

Objective

To quantitatively measure the rate of growth of vertebral bodies in juvenile idiopathic scoliosis (JIS) treated with vertebral body stapling (VBS).

Summary of background data

VBS has been suggested to be a safe and effective method for modulating the growth of the young scoliotic spine, but few long-term studies have examined its efficacy.

Methods

Seven patients with JIS 11 years of age or younger underwent VBS with a minimum 6-year follow-up. Vertebral body height on the unstapled and stapled aspects of the curve was measured from initial and final postoperative radiographs and converted into rate of growth per year. Known staple dimensions were used to standardize the measurements between radiographs. Interstaple distance was measured to demonstrate continued growth of the spine. Adjacent vertebral bodies without instrumentation served as an internal control of growth. Each vertebral body (n = 35) was analyzed as an individual experimental unit.

Results

The average rate of growth was 0.86 mm/year (standard deviation [SD] 0.44, 95% confidence interval [CI] 0.71–1.0) per vertebral body on the stapled side and 0.83 mm/year (SD 0.46, 95% CI 0.67–0.98) per vertebral body on the unstapled side of the vertebral body. The adjacent vertebral body segments grew at a rate of 0.91 mm/year (SD 0.42, 95% CI 0.66–1.15) on the stapled side and 0.99 mm/year (SD 0.66, 95% CI 0.61–1.37) on the unstapled side, p < 0.01. The distance between staples increased significantly from 3.0 mm (SD 2.0, 95% CI 2.3–3.6) to 8.4 mm (SD 2.4, 95% CI 7.7–9.3).

Conclusions

Vertebral body growth in the presence of VBS occurred at a similar rate on the stapled and unstapled sides of the curve. The high standard deviation of instrumented segment growth further supports the conclusion that VBS is not a reliable method of growth modulation in the young scoliotic spine.

Level of evidence

IV.

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Funding

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Authors and Affiliations

  1. University of Missouri-Kansas City, 5100 Rockhill Rd, Kansas City, MO, 64110, USA

    Erin Murray

  2. University of Kansas School of Medicine, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA

    Robert Tung

  3. Orthopaedics and Pediatrics, Children’s Mercy Hospital, 2401 Gillham Road, 2nd floor Annex, Kansas City, MO, 64108, USA

    Ashley Sherman & Richard M. Schwend

Authors
  1. Erin Murray
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  2. Robert Tung
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  3. Ashley Sherman
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  4. Richard M. Schwend
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Corresponding author

Correspondence to Richard M. Schwend.

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Conflict of interest

EM, RT, AS, and RMS have no conflicts of interest.

Ethical approval

Reviewed and approved by the Pediatric IRB at The Children’s Mercy Hospital & Clinics (IRB # 15080376).

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Murray, E., Tung, R., Sherman, A. et al. Continued vertebral body growth in patients with juvenile idiopathic scoliosis following vertebral body stapling. Spine Deform 8, 221–226 (2020). https://doi.org/10.1007/s43390-019-00019-x

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  • DOI: https://doi.org/10.1007/s43390-019-00019-x

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