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Spinal height for growth guidance treatment in early onset idiopathic scoliosis: analysis through final surgical treatment

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Abstract

Background

The growth guidance (GG) method for treatment of early onset scoliosis has as its primary goal the restoration of apical spinal alignment, facilitating normal spinal growth to achieve a suitable adult thoracic height.

Purpose

To evaluate whether GG surgical treatment achieves comparable thoracic and spinal height to distraction-based treatment (DBT) in idiopathic early onset scoliosis (I-EOS) patients. We hypothesized that GG would prove superior to DBT at the time of definitive fusion surgery.

Methods

All I-EOS patients who underwent GG at a single center were reviewed. T1–L1 and T1–S1 heights were measured using the traditional coronal method as well as the Halifax sagittal spinal length (SSL) technique. The same measurements were obtained from a comparable control group obtained from a multi-center pediatric early onset scoliosis database who underwent treatment with traditional growing rods (TGR) or magnetically controlled growing rods (MCGR).

Results

Of the I-EOS patients who underwent GG 2004–2019, 15 patients underwent final fusion after GG completion, with a mean 5.5 years of GG treatment prior to fusion (range 2.0–11.4 years). Mean age at GG implantation was 8.4 years (range 2.0–11.7 years); 7 were male and 8 female. GG patients experienced a mean coronal thoracic height increase of 6.2 cm during treatment through final fusion, and a mean coronal spinal height increase of 8.8 cm. At the time of final fusion, GG patients achieved greater significant mean increases than DBT patients by 2.9 cm in coronal thoracic height (p = 0.0023), 4.5 cm in coronal spinal height (p = 0.001), and 4.0 cm in SSL spinal height (p = 0.01). No GG patient concluded treatment with a thoracic height less than 18 cm in either coronal or sagittal plane.

Conclusions

Not only did 100% of GG patients reach minimum thoracic height of 18 cm at time of final fusion, but GG also proved to be superior to distraction-based constructs in a comparison cohort on 3 of 4 spinal elongation measures.

Level of evidence.

3.

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

Authors

Contributions

Cornaghie: Data Collection. Data analysis. Writing—original draft preparation, approval of final version of manuscript, agree to be accountable for the work. Bumpass: Writing—editing, data collection, approval of final version, agree to be accountable for the work. McCarthy: Study conception, data collection, approval of final version, agree to be accountable for the work. Siegel: Statistical analysis, writing—original draft preparation, approval of final version, agree to be accountable for work. Roeder: Data Collection, approval of final version of manuscript, agree to be accountable for the work.

Corresponding author

Correspondence to Meg Cornaghie.

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Conflict of interest

Authors M. Cornaghie, L. Roeder, and E.R. Siegel have no financial interests to disclose. Author D. Bumpass has received a consulting and speaking fee from Medtronic. Author R. McCarthy has received a consulting and speaking fee from Medtronic and OrthoPediatrics.

Ethical approval

This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Institutional Review Board of the University of Arkansas approved this study.

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Informed consent was exempted due to the type of research.

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Cornaghie, M., Bumpass, D., Roeder, L. et al. Spinal height for growth guidance treatment in early onset idiopathic scoliosis: analysis through final surgical treatment. Spine Deform (2024). https://doi.org/10.1007/s43390-024-00891-2

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