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Comparing health-related quality of life and burden of care between early-onset scoliosis patients treated with magnetically controlled growing rods and traditional growing rods: a multicenter study

Abstract

Study design

Multicenter retrospective cohort study.

Objectives

To compare pre-operative and post-operative EOSQ-24 scores in magnetically controlled growing rods (MCGR) and traditional growing rod (TGR) patients.

Summary of background data

Since the introduction of MCGR, early-onset scoliosis patients have been afforded a reduction in the number of surgeries compared to the TGR technique. However, little is known about (health-related quality of life) and burden of care outcomes between these surgical techniques.

Methods

This is a retrospective cohort study using a multicenter registry on patients with EOS undergoing MCGR or TGR between 2008 and 2017. The EOSQ-24 was administered at preoperative and postoperative 2-year assessments. The EOSQ-24 scores were compared between MCGR and TGR as well as preoperatively and postoperatively within each procedure.

Results

110 patients were analyzed in this study (TGR, N = 32; MCGR, N = 78). There were no significant differences in preoperative age, gender, etiology, main coronal curve or maximum kyphosis between TGR and MCGR groups. Patients with TGR had averaged 3.9 surgical lengthenings and MCGR had averaged 7.7 non-invasive lengthenings by the 2-year follow-up. When changes in preoperative to postoperative scores were compared, MCGR had more improvements in pain, emotion, child satisfaction and parent satisfaction than TGR although there were no statistical significance. When analyzed separately, MCGR cohort had improvement in scores for all four domains and four sub-domains; while, TGR cohort only had improvement in financial burden domain and pulmonary function sub-domain.

Conclusion

Although there was no statistical significance, the improvement in pain, emotion and satisfaction scores was larger in MCGR than TGR. Since these areas can be influenced more by mental well-being than other sub-domains, the results may prove our hypothesis that compared to TGR, MCGR with reduced number of surgeries have better psychosocial effects.

Level of evidence

III.

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Acknowledgements

All participating sites in this study obtained IRB approval from their respective institutions prior to study initiation.

Funding

NuVasive Inc. provided research support and funded by Pediatric Spine Study Group (Grant number: CSSG0074) for this study.

Author information

Affiliations

Authors

Consortia

Contributions

Hiroko Matsumoto, PhDc: Study idea, study design, Data analysis, manuscript preparation/review, final approval of manuscript. David L. Skaggs, MD, MMM: Study idea, study design, manuscript review, final approval of manuscript. Behrooz A. Akbarnia, MD: Study idea, study design, manuscript review, final approval of manuscript. Jeff B. Pawelek, BS: Study design, data analysis, manuscript review, final approval of manuscript. Tricia St. Hilaire, MPH: Study design, data analysis, manuscript review, final approval of manuscript. Sonya Levine, BA: Study design, data analysis, manuscript preparation/review, final approval. Peter Sturm, MD, MBA: Study design, data analysis, manuscript review, final approval of manuscript. Francisco Javier Sanchez Perez-Grueso, MD: Study design, data analysis, manuscript review, final approval of manuscript. Scott J. Luhmann, MD: Study design, data analysis, manuscript review, final approval of manuscript. Paul D. Sponseller, MD, MBA: Study design, data analysis, manuscript review, final approval of manuscript. John T. Smith, MD: Study design, data analysis, manuscript review, final approval of manuscript. Klane K. White, MD: Study design, data analysis, manuscript review, final approval of manuscript. Michael G. Vitale, MD, MPH: Study idea, study design, manuscript review, final approval of manuscript. Pediatric Spine Study Group: Data collection, data analysis, manuscript review, final approval of manuscript.

Corresponding author

Correspondence to David L. Skaggs.

Ethics declarations

Conflict of interest

Hiroko Matsumoto, PhDc: Grants from Scoliosis Research Society, grants from Pediatric Orthopaedic Society of North America. David L. Skaggs, MD, MMM: CHLA Foundation: Board or committee member; Grand Rounds: Paid consultant; Green Sun Medical: Stock or stock Options; Growing Spine Foundation: Board or committee member; Growing Spine Study Group: Board or committee member; Journal of Children’s Orthopaedics: Editorial or governing board; Medtronic: Other financial or material support; Nuvasive (Co-PI, Paid to Growing Spine Foundation): Research support; Orthobullets: Editorial or governing board; Paid consultant; Stock or stock Options; Orthopedics Today: Editorial or governing board; Spine Deformity: Editorial or governing board; Wolters Kluwer Health: Publishing royalties, financial or material support; ZimmerBiomet: IP royalties; Other financial or material support; Paid consultant; Paid presenter or speaker; Zipline Medical, Inc.: Stock or stock Options. Behrooz A. Akbarnia, MD: Grants, Royalties, Consultant: Nuvasive, Royalties: DePuy Synthes, Royalties: K2M, Stock/Stock options: Viseon, NociMed, grants from SeaSpine. Jeff B. Pawelek, BS: Volunteer board member, San Diego Spine Foundation. Tricia St. Hilaire, MPH: No conflicts of interest to disclose. Sonya Levine, BA: No conflicts of interest to disclose. Peter Sturm, MD, MBA: Personal fees and surgical advisory board from DePuy Synthes Spine, Consultant: NuVasive, Shareholder: Green Sun Medical, Editorial board: Journal of Children’s Orthopaedics. Francisco Javier Sanchez Perez-Grueso, MD: No conflicts of interest to disclose. Scott J. Luhmann, MD: Personal fees from Stryker, Medtronic, Orthopaediatrics, Globus, Wolters Kluwer, and Wishbone. Paul D. Sponseller, MD, MBA: Grants and personal fees from DePuy Synthes, personal fees from Globus, and Orthopediatrics. John T. Smith, MD: Royalties: Globus, Consultant: Nuvasive, Wishbone, Green Sun Medical, Board of Directors: Scoliosis Research Society, Children’s Spine Foundation. Klane K. White, MD: Grants and personal fees from Biomarin, grants from Ultragenyx, grants from Ascendis, grants from Theracon, personal fees from UptoDate.com. Michael G. Vitale, MD, MPH: Grants from Children’s Spine Foundation, grants from Orthopaedic Scientific Research Foundation, grants from SRS, grants from POSNA, Consultant: Stryker, Biomet, NuVasive, Royalties: Biomet. Pediatric Spine Study Group: Research support from POSNA, FDA, NuVasive, DePuy Synthes Spine, Growing Spine Foundation, Children’s Spine Foundation.

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Appendix

Appendix

See Table 6.

Table 6 Sensitivity analysis comparing patient characteristics between eligible patients and patients included in analyses

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Matsumoto, H., Skaggs, D.L., Akbarnia, B.A. et al. Comparing health-related quality of life and burden of care between early-onset scoliosis patients treated with magnetically controlled growing rods and traditional growing rods: a multicenter study. Spine Deform 9, 239–245 (2021). https://doi.org/10.1007/s43390-020-00173-7

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Keywords

  • Early-onset scoliosis
  • Magnetically controlled growing rods
  • Traditional growing rods
  • Health-related quality of life