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The role of traditional growing rods in the era of magnetically controlled growing rods for the treatment of early-onset scoliosis

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Abstract

Purpose

To describe the clinical and radiographic profile of early-onset scoliosis (EOS) patients treated with traditional growing rods (TGR) during the magnetically-controlled growing rod (MCGR) era.

Methods

A US multicenter EOS database was reviewed to identify (1) patients who underwent TGR after MCGR surgery was introduced at their institution, (2) patients who underwent MCGR during the same time period. Of 19 centers, 8 met criteria with all EOS etiologies represented. Clinical notes were reviewed to determine the indication for TGR. Patient demographics and pre-operative radiographs were compared between groups.

Results

A total of 25 TGR and 127 MCGR patients were identified. The TGR patients were grouped by indication into the sagittal plane profile (n = 11), trunk height (n = 6), co-morbidities/need for MRI (n = 4), and other (ex: behavioral issues, remaining growth). Four patients had a combination of sagittal profile and short stature with sagittal profile listed as primary factor. The TGR short trunk group had a mean T1–S1 length of 192 mm vs 273 mm for the MCGR group (p = 0.0002). The TGR sagittal profile group, had a mean maximal kyphosis of 61° vs 55° for the MCGR group (p = 0.09).

Conclusion

TGR continues to have a role in the MCGR era. In this study, the most commonly reported indications for TGR were sagittal plane profile and trunk height. These results suggest that TGR is indicated in patients of short stature with stiff hyperkyphotic curves. As further experience is gained with MCGR, the indications for TGR will likely be refined.

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Acknowledgements

Pediatric Spine Study Group (Abdullah Saad Abdulfattah Abdullah MBChB, MRCS, Behrooz Akbarnia MD, Jason Anari MD, John Anderson MD, Richard Anderson MD, Lindsay Andras MD, Laura Bellaire MD, Randy Betz MD, Craig Birch MD, Laurel Blakemore MD, Oheneba Boachie-Adjei MD, Chris Bonfield MD, Douglas Brockmeyer MD, Jaysson Brooks MD, Pat Cahill MD, Jason Cheung MD, Kenneth Cheung MD, FRCS, FHKCOS, FHKAM, Haemish Crawford MD, Alvin Crawford MD, FACS, Gokhan Demirkiran PhD, Hazem El Sebaie MD, FRCS, Ron El-Hawary MD, MSc, FRCS(c), John Emans MD, Mark Erickson MD, Frances Farley MD, Graham Fedorak MD, Ryan Fitzgerald MD, Nicholas Fletcher MD, Lorena Floccari MD, Jack Flynn MD, Peter Gabos MD, Adrian Gardner MD, Sumeet Garg MD, Michael Glotzbecker MD, Jaime Gomez MD, Tenner Guillaume MD, Purnendu Gupta MD, Kyle Halvorson MD, Kim Hammerberg MD, Christina Hardesty MD, Daniel Hedequist MD, Michael Heffernan MD, John Heflin MD, Ilkka Helenius MD, PhD, Grant Hogue MD, Josh Holt MD, Jason Howard MD, Michael Timothy Hresko MD, Steven Hwang MD, Stephanie Ihnow MD, Brice Ilharreborde MD, PhD, Kenneth Illingworth MD, Andrew Jea MD, Charles Johnston MD, Judson Karlen MD, Lawrence Karlin MD, Noriaki Kawakami MD, Brian Kelly MD, Kenny Kwan BMBCh, FRCSEd, FHKCOS, FHKAM, Robert Lark MD, A. Noelle Larson MD, William Lavelle MD, Sean Lew MD, Gertrude Li MD, Scott Luhmann MD, Stuart Mackenzie MD, Sanchez Marquez MD, Jonathan Martin MD, Jeffrey Martus MD, MS, Oscar Mayer MD, Amy McIntosh MD, Jwalant Mehta MD, Daniel Miller MD, Firoz Miyanji MD, Greg Mundis MD, Josh Murphy MD, Robert Murphy MD, Susan Nelson MD, MPH, Peter Newton MD, Matthew Oetgen MD, MBA, Josh Pahys MD, Stefan Parent MD, PhD, Javier Pizones MD, PhD, Selina Poon MD, Nigel Price MD, Norman Ramirez-Lluch MD, Brandon Ramo MD, Gregory Redding MD, Luis Rodriguez MD, David Roye MD, Benjamin Roye MD, Lisa Saiman MD, PhD, Amer Samdani MD, Francisco Sanchez Perez-Grueso MD, James Sanders MD, Jeffrey Sawyer MD, Jacob Schulz MD, Richard Schwend MD, Suken Shah MD, David Skaggs MD, MMM, Kevin Smit MD, FRCSC, John Smith MD, Brian Snyder MD, PhD, Paul Sponseller MD, Peter Sturm MD, Michal Szczodry MD, John Thometz MD, George Thompson MD, Walter Truong MD, Raphael Vialle MD, Michael Vitale MD, MPH, John Vorhies MD, Stuart Weinstein MD, Michelle Welborn MD, Klane White MD, Burt Yaszay MD, Muharrem Yazici MD) are affiliated with Children’s Spine Foundation, Valley Forge, PA, USA.

Funding

No funding was received for this study.

Author information

Authors and Affiliations

  1. Spine Institute of Idaho, Boise, ID, USA

    Eric S. Varley

  2. San Diego Spine Foundation, San Diego, CA, USA

    Jeff B. Pawelek

  3. Division of Orthopedics and Scoliosis, Rady Children’s Hospital, 3020 Children’s Way, MC 5062, San Diego, CA, 92123, USA

    Greg M. Mundis Jr., Behrooz A. Akbarnia & Burt Yaszay

  4. Division of Orthopaedic Surgery and Sports Medicine, Children’s National Hospital, Washington, DC, USA

    Matthew E. Oetgen

  5. Division of Orthopaedic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Peter F. Sturm

Authors
  1. Eric S. Varley
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  2. Jeff B. Pawelek
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  3. Greg M. Mundis Jr.
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  4. Matthew E. Oetgen
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  5. Peter F. Sturm
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  6. Behrooz A. Akbarnia
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  7. Burt Yaszay
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Consortia

Pediatric Spine Study Group

  • Abdullah Saad Abdulfattah Abdullah
  • , Behrooz Akbarnia
  • , Jason Anari
  • , John Anderson
  • , Richard Anderson
  • , Lindsay Andras
  • , Laura Bellaire
  • , Randy Betz
  • , Craig Birch
  • , Laurel Blakemore
  • , Oheneba Boachie-Adjei
  • , Chris Bonfield
  • , Douglas Brockmeyer
  • , Jaysson Brooks
  • , Pat Cahill
  • , Jason Cheung
  • , Kenneth Cheung
  • , Haemish Crawford
  • , Alvin Crawford
  • , Gokhan Demirkiran
  • , Hazem El Sebaie
  • , Ron El-Hawary
  • , John Emans
  • , Mark Erickson
  • , Frances Farley
  • , Graham Fedorak
  • , Ryan Fitzgerald
  • , Nicholas Fletcher
  • , Lorena Floccari
  • , Jack Flynn
  • , Peter Gabos
  • , Adrian Gardner
  • , Sumeet Garg
  • , Michael Glotzbecker
  • , Jaime Gomez
  • , Tenner Guillaume
  • , Purnendu Gupta
  • , Kyle Halvorson
  • , Kim Hammerberg
  • , Christina Hardesty
  • , Daniel Hedequist
  • , Michael Heffernan
  • , John Heflin
  • , Ilkka Helenius
  • , Grant Hogue
  • , Josh Holt
  • , Jason Howard
  • , Michael Timothy Hresko
  • , Steven Hwang
  • , Stephanie Ihnow
  • , Brice Ilharreborde
  • , Kenneth Illingworth
  • , Andrew Jea
  • , Charles Johnston
  • , Judson Karlen
  • , Lawrence Karlin
  • , Noriaki Kawakami
  • , Brian Kelly
  • , Kenny Kwan
  • , Robert Lark
  • , A. Noelle Larson
  • , William Lavelle
  • , Sean Lew
  • , Gertrude Li
  • , Scott Luhmann
  • , Stuart Mackenzie
  • , Sanchez Marquez
  • , Jonathan Martin
  • , Jeffrey Martus
  • , Oscar Mayer
  • , Amy McIntosh
  • , Jwalant Mehta
  • , Daniel Miller
  • , Firoz Miyanji
  • , Greg Mundis
  • , Josh Murphy
  • , Robert Murphy
  • , Susan Nelson
  • , Peter Newton
  • , Matthew Oetgen
  • , Josh Pahys
  • , Stefan Parent
  • , Javier Pizones
  • , Selina Poon
  • , Nigel Price
  • , Norman Ramirez-Lluch
  • , Brandon Ramo
  • , Gregory Redding
  • , Luis Rodriguez
  • , David Roye
  • , Benjamin Roye
  • , Lisa Saiman
  • , Amer Samdani
  • , Francisco Sanchez Perez-Grueso
  • , James Sanders
  • , Jeffrey Sawyer
  • , Jacob Schulz
  • , Richard Schwend
  • , Suken Shah
  • , David Skaggs
  • , Kevin Smit
  • , John Smith
  • , Brian Snyder
  • , Paul Sponseller
  • , Peter Sturm
  • , Michal Szczodry
  • , John Thometz
  • , George Thompson
  • , Walter Truong
  • , Raphael Vialle
  • , Michael Vitale
  • , John Vorhies
  • , Stuart Weinstein
  • , Michelle Welborn
  • , Klane White
  • , Burt Yaszay
  •  & Muharrem Yazici

Contributions

ESV, JBP, GMMJr, MEO, PFS, BAA, PSSG, BY design, data acquisition, analysis and/or interpretation of work, manuscript drafting and/or critically revising, manuscript drafting and/or critically revising, final approval.

Corresponding author

Correspondence to Burt Yaszay.

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Varley, E.S., Pawelek, J.B., Mundis Jr., G.M. et al. The role of traditional growing rods in the era of magnetically controlled growing rods for the treatment of early-onset scoliosis. Spine Deform 9, 1465–1472 (2021). https://doi.org/10.1007/s43390-021-00332-4

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