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Radiographic Outcome Differences in Distraction-Based Growing Rod Constructs Using Tandem Versus Wedding Band Connectors

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Abstract

Study Design

Comparative cohort study.

Objective

To compare coronal deformity control, lengthening efficacy, and sagittal alignment between distraction-based growing rod constructs utilizing tandem versus wedding band connectors.

Summary of Background Data

Different construct designs exist for growing rod treatment of early-onset scoliosis. All use a version of a rod connector, with the two main types being tandem and wedding band. Little data exist to quantify the impact of connector choice on radiographic outcomes of treatment.

Methods

A multicenter database of prospectively and retrospectively collected data on early-onset scoliosis patients was reviewed. Patients of any thoracic or thoracolumbar coronal plane deformity whose initial growing rod treatment was initiated before age 10 years and underwent at least 3 years of dual growing rod treatment with either tandem or wedding band connectors were included. Preoperative, immediate postoperative, and prefinal radiographs were reviewed and compared in regard to major curve magnitude, T1–T12 and T1–S1 spinal length, length of instrumentation, and sagittal plane measures.

Results

A total of 209 patients were included. The overall percent change from preoperative to prefinal in all radiographic parameters was not different between the two groups indicating similar efficacy in treatment. After controlling for institutional variation, the improvement of the major coronal Cobb angle from preoperative to prefinal was statistically improved for the tandem group (34° vs. 29°, p = .002) and the difference in T5–T12 kyphosis from preoperative to prefinal was significantly different between the groups (−6° vs. +1.3°, p = .008).

Conclusion

We identified little difference in the effects of connector type on radiographic outcomes of patients treated with traditional growing rod, which indicates that both wedding band and tandem connectors function similarly. The small differences detected suggest that tandem connectors may improve major Cobb correction, and wedding band connectors may maintain thoracic kyphosis over time.

Level of Evidence

Level III

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Author information

Authors and Affiliations

  1. Division of Orthopaedic Surgery and Sports Medicine, Children’s National Health System, 111 Michigan Avenue, NW, 20010, Washington, DC, USA

    Matthew E. Oetgen MD, MBA, Allison Matthews MS & Yunfei Wang PhD

  2. University of Florida Health, Department of Orthopaedics and Rehabilitation, 3450 Hull Road, 32611, Gainesville, FL, USA

    Laurel Blakemore MD

  3. Growing Spine Foundation, 6190 Cornerstone Ct East, Ste 212, 92121, San Diego, CA, USA

    Jeff Pawelek BS, Anna McClung BSN, RN & Behrooz Akbarnia MD

  4. Johns Hopkins Children’s Center, 1800 Orleans Street, Room 75359A, 21287, Baltimore, MD, USA

    Paul Sponseller MD

  5. Hospital Universitario La Paz, Pedro Rico 31.8G, 28029, Madrid, Spain

    Francisco Sanchez Perez-Grueso MD

Authors
  1. Matthew E. Oetgen MD, MBA
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  2. Allison Matthews MS
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  3. Yunfei Wang PhD
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  4. Laurel Blakemore MD
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  5. Jeff Pawelek BS
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  6. Anna McClung BSN, RN
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  7. Paul Sponseller MD
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  8. Francisco Sanchez Perez-Grueso MD
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  9. Behrooz Akbarnia MD
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Consortia

Growing Spine Study Group

Corresponding author

Correspondence to Matthew E. Oetgen MD, MBA.

Additional information

Author disclosures: MEO (personal fees from Children’s National Medical Center, grants from Pediatric Orthopaedic Society of America, grants from Children’s National Medical Center Board of Visitors, grants from Joseph E Robert, Jr. Endowment for Surgical Care, grants from Orthopaedic Research and Education Foundation/Regents of the University of Minnesota, grants from CareFusion Foundation, outside the submitted work), AM (personal fees from Children’s National Medical Center, outside the submitted work), YW (none), LB (personal fees from K2M Medical, during the conduct of the study; other from Spine Deformity Journal, outside the submitted work), JP (none), AM (none), PS (personal fees from JBJS, grants and personal fees from DePuy, personal fees from Oakstone Medical Publisher, from Globus, during the conduct of the study), FSP-G (grants from DePuy Synthes, personal fees from K2M, outside the submitted work), BA (grants and personal fees from NuVasive, personal fees from K2M, personal fees from DePuy Spine, personal fees from NociMed, outside the submitted work), Growing Spine Study Group (grants from Growing Spine Foundation, during the conduct of the study; grants from NuVasive, outside the submitted work).

Funding statement: The Growing Spine Foundation financially supports the Growing Spine Study Group, the multi-center study group that provided the data for this research study. The Growing Spine Foundation receives funding support from its surgeon members, patients, other donors, and the medical device industry.

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Oetgen, M.E., Matthews, A., Wang, Y. et al. Radiographic Outcome Differences in Distraction-Based Growing Rod Constructs Using Tandem Versus Wedding Band Connectors. Spine Deform 6, 314–319 (2018). https://doi.org/10.1016/j.jspd.2017.10.014

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  • DOI: https://doi.org/10.1016/j.jspd.2017.10.014

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