Newsletter
Language
Language:
 
News
Archival Issues
Volume 18, 2016
Volume 17, 2015
Volume 16, 2014
Volume 15, 2013
Volume 14, 2012
Volume 13, 2011
Volume 12, 2010
Volume 11, 2009
Volume 10, 2008
Volume 9, 2007
Volume 8, 2006
Volume 7, 2005
Volume 6, 2004
Volume 5, 2003
Volume 4, 2002
Volume 3, 2001
Volume 2, 2000
Volume 1, 1999
Search
 » 
Journal Abstract
 
Guided-growth implants in the treatment of early onset scoliosis – pilot study
Michał Latalski , Marek Fatyga, Krzysztof Kołtowski, Piotr Menartowicz, Martin Repko , Milan Filipovič
Ortop Traumatol Rehabil 2013; 15(1):23-29
ICID: 1032798
Article type: Original article
IC™ Value: 3.00
Abstract provided by Publisher
 
Introduction. The aim of treating children with early onset scoliosis is to guide the growth of the spine until the patients reach skeletal maturity. Regardless of its aetiology, progressive early-onset scoliosis requires multiple-stage surgery, usually at 6 to 12 months’ intervals. However, precise coordination of the timing of each consecutive surgical procedure with the child’s growth pattern is difficult, and the risk of complications that require additional surgery should be taken into account. Aim of the study. The aim of this study is to present a new surgical method of treating early onsetscoliosis which consists in a single-stage insertion of special implants that enable three-plane correction of spinal deformities, allows the spine to continue growing, does not require multi-stage surgical distractions, and ends after the growth period with a conventional spinal fusion. The results of this pilot study were obtained in a homogeneous group of patients treated identically by insertion of original implants guiding spinal growth. Materials. The study involved 15 females and 2 males aged between 5 and 13 years (mean age: 9.8 years). All children in the study group had single-curve thoracic scoliosis. The duration of follow-up was between 6 and 40 months (mean duration: 18 months). Methods. The efficacy of the guided-growth implant treatment was assessed based on standard radiographs by evaluating the angle of the curvature, T1-S1 length, and apical vertebral rotation (AVR) 1.) preoperatively, 2.) postoperatively, and 3.) in long-term follow-up. Results. After surgery the scoliosis improved significantly in the range of 51% to 80% (mean improvement: 65%). The degree of the correction depended directly on the initial angle of curvature, which ranged from 56 to 95° (mean angle of curvature: 67°). During the entire follow-up period, twelve patients did not show any loss of correction, or the loss was within the bounds of measurement error. Because of a growth spurt, two female patients had to have the rods replaced with longer ones, since there was a risk that they might slide out of the farthest lower screws. In three patients further spontaneous improvement occurred during the follow-up period. Apical vertebral derotation was achieved during the surgery in all patients, and it was maintained throughout the follow-up period. All patients showed an increase in spinal length in the range of 7 to 40 mm (mean increase: 1mm/month).
Conclusions.
1. The surgical method described by us provides for very good correction in the first stage of treatment.
2. The maintenance of the correction does not require the use of corrective braces or any indirect multi-stage surgical procedures.
3. The probability of complications during the insertion of the implants is not higher than that seen with conventional multi-stage treatment.

ICID 1032798

DOI 10.5604/15093492.1032798
 
FULL TEXT 1829 KB


Related articles
  • in IndexCopernicus™
         dzieci [380 related records]
         implanty guided-growth [0 related records]
         children [1109 related records]
         guided-growth implants [0 related records]
         Scoliosis [110 related records]


  •  

    Copyright © Ortopedia Traumatologia Rehabilitacja  2017
    Page created by Index Copernicus Ltd. All Rights reserved.