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Comparison of Percentile Weight Gain of Growth-Friendly Constructs in Early-Onset Scoliosis

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Abstract

Study Design

Multicenter retrospective cohort.

Objective

To compare improvement in nutritional status seen in early-onset scoliosis (EOS) patients following treatment with various growth-friendly techniques, especially in underweight patients (<20th weight percentile).

Background

Thoracic insufficiency resulting from EOS can lead to severe cardiopulmonary disease. In this age group, pulmonary function tests are often difficult or impossible to perform. Weight gain has been used in prior studies as a proxy for improvement and has been demonstrated following VEPTR and growing rod implantation. In this study, we aim to analyze weight gain of EOS patients treated with four different spinal implants to evaluate if significant differences in weight percentile change exist between them.

Methods

Retrospective review of patients treated surgically for EOS was performed from a multicenter database. Exclusion criteria were index instrumentation at >10 years old and <2 years’ follow-up.

Results

287 patients met the inclusion criteria and etiologies were as follows: congenital = 85; syndromic = 79; neuromuscular = 69; and idiopathic = 52. Average patient age at surgery was 5.41 years, with an average follow-up of 5.8 years. Preoperatively, 55.4% (162/287) fell below the 20th weight percentile. There was no significant difference in preoperative weight between implants (p = .77), or diagnoses (p = .25). Among this group, the mean change in weight percentile was 10.5% (range: −16.7% to 88.7%) and all implant groups increased in mean weight percentile at final follow-up. There were no significant differences in weight percentile change between the groups when divided by implant type (p = .17).

Conclusions

Treatment of EOS with growth-friendly constructs resulted in an increase in weight percentile for underweight patients (<20th percentile), with no significant difference between constructs.

Level of Evidence

Lever III.

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Author information

Authors and Affiliations

  1. Children’s Orthopaedic Center, Children’s Hospital Los Angeles, 4650 Sunset Blvd, Mailstop #69, Los Angeles, CA, 90027, USA

    Liam R. Harris MD, Lindsay M. Andras MD & David L. Skaggs MD, MMM

  2. Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, 21218, USA

    Paul D. Sponseller MD

  3. Department of Orthopaedic Surgery, Texas Scottish Rite Hospital for Children, 2222 Welborn St, Dallas, TX, 75219, USA

    Charles E. Johnston MD

  4. Department of Orthopaedic Surgery, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA, 02115, USA

    John B. Emans MD

Authors
  1. Liam R. Harris MD
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  2. Lindsay M. Andras MD
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  3. Paul D. Sponseller MD
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  4. Charles E. Johnston MD
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  5. John B. Emans MD
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  6. David L. Skaggs MD, MMM
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Consortia

Growing Spine Study Group

Corresponding author

Correspondence to David L. Skaggs MD, MMM.

Additional information

IRB Approval

This study has been carried out with approval from the Institutional Review Board at Children’s Hospital Los Angeles.

Author disclosures

LRH (none); LMA (personal fees from Biomet; Medtronic, other from Eli Lilly, personal fees and other from Orthobullets, other from Pediatric Orthopaedic Society of North America; Scoliosis Research Society, outside the submitted work); PDS (none); CEJ (personal fees from Medtronic Sofamor Danek, other from Orthopaedics, Journal of Children’s Orthopedics, other from Pediatric Orthopaedic Society of North America; Scoliosis Research Society, personal fees from Saunders/Mosby-Elsevier, outside the submitted work); JBE (other from Journal of Children’s Orthopedics, personal fees from Medtronic Sofamor Danek, personal fees from Synthes, outside the submitted work); DLS (grants from Pediatric Orthopaedic Society of North America & Scoliosis Research Society, paid to Columbia University; Ellipse [co—principal investigator, paid to GSF]; personal fees from ZimmerBiomet, Medtronic, Zipline Medical, Inc., Orthobullets, Grand Rounds [a healthcare navigation company], Green Sun Medical, Johnson & Johnson, Wolters Kluwer Health—Lippincott Williams & Wilkins, Biomet Spine; other from Zipline Medical, Inc., Green Sun Medical, Growing Spine Study Group, Scoliosis Research Society, Growing Spine Foundation, Medtronic & ZimmerBiomet, Orthobullets, outside the submitted work); Growing Spine Study Group (none).

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Harris, L.R., Andras, L.M., Sponseller, P.D. et al. Comparison of Percentile Weight Gain of Growth-Friendly Constructs in Early-Onset Scoliosis. Spine Deform 6, 43–47 (2018). https://doi.org/10.1016/j.jspd.2017.05.005

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  • DOI: https://doi.org/10.1016/j.jspd.2017.05.005

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