nach oben

Erschienen in:

01.07.2015 | Original Article

Dual growing rod treatment in early onset scoliosis: the effect of repeated lengthening surgeries on thoracic growth and dimensions

verfasst von: Zhi-jian Sun, Gui-xing Qiu, Yu Zhao, Shi-gong Guo, Jian-guo Zhang, Jian-xiong Shen, Yi-Peng Wang, Hong Zhao, Shu-gang Li

Erschienen in: European Spine Journal | Ausgabe 7/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To investigate changes in thoracic dimensions (TDs) following repeated lengthening surgeries after dual growing rod treatment of early onset scoliosis and thereby its effect on thoracic growth.

Methods

All EOS patients treated with dual growing rod technique in Peking Union Medical College Hospital from June 2004 to June 2014 were retrospectively reviewed. Thoracic spine height (T1–T12), total spine height (T1–S1), maximal coronal chest width and pelvic inlet width (PIW) were measured on the posteroanterior X-ray images after initial growing rod insertion surgery and after each lengthening surgery. Absolute TDs measurements were normalized by PIW. Changes of absolute and normalized TDs measurements with age and number of lengthening surgeries were analyzed.

Results

Radiographs of 229 surgeries of 53 EOS patients were measured, including 49 images after initial growing rod insertion surgery and 180 images of lengthening surgeries. Significant positive correlations between age and all three absolute TDs were found (P < 0.01) whereas significant negative correlations between age and all three normalized TDs (P < 0.01) were identified. Similarly, negative correlations were also identified between number of lengthening surgeries and the three normalized TDs (P < 0.01). Significant differences of normalized TDs were identified between initial surgery and the first lengthening through covariance analysis (P < 0.01). Yet, such differences were seldom seen between every two adjacent lengthening surgeries.

Conclusions

Growing rod technique could maintain TDs growth through repeated lengthening procedures but the growth rate was compromised as the number of lengthening procedures increased.

Tis JE, Karlin LI, Akbarnia BA, Blakemore LC, Thompson GH, McCarthy RE, Tello CA, Mendelow MJ, Southern EP (2012) Early onset scoliosis: modern treatment and results. J Pediatr Orthop 32:647–657. doi:10.1097/BPO.0b013e3182694f18 PubMedView Article
Kamaci S, Demirkiran G, Ismayilov V, Olgun ZD, Yazici M (2014) The effect of dual growing rod instrumentation on the apical vertebral rotation in early-onset idiopathic scoliosis. J Pediatr Orthop. doi:10.1097/BPO.0000000000000169 PubMed
Akbarnia BA, Cheung K, Noordeen H, Elsebaie H, Yazici M, Dannawi Z, Kabirian N (2013) Next generation of growth-sparing techniques: preliminary clinical results of a magnetically controlled growing rod in 14 patients with early-onset scoliosis. Spine (Phila Pa 1976) 38:665–670. doi:10.1097/BRS.0b013e3182773560 View Article
Wang S, Zhang J, Qiu G, Wang Y, Li S, Zhao Y, Shen J, Weng X (2012) Dual growing rods technique for congenital scoliosis: more than 2 years outcomes: preliminary results of a single center. Spine (Phila Pa 1976) 37:E1639–E1644. doi:10.1097/BRS.0b013e318273d6bf View Article
McElroy MJ, Sponseller PD, Dattilo JR, Thompson GH, Akbarnia BA, Shah SA, Snyder BD (2012) Growing rods for the treatment of scoliosis in children with cerebral palsy: a critical assessment. Spine (Phila Pa 1976) 37:E1504–E1510. doi:10.1097/BRS.0b013e31826fabd3 View Article
Caniklioglu M, Gokce A, Ozturkmen Y, Gokay NS, Atici Y, Uzumcugil O (2012) Clinical and radiological outcome of the growing rod technique in the management of scoliosis in young children. Acta Orthop Traumatol Turc 46:379–384PubMed
Zhao Y, Qiu GX, Wang YP, Zhang JG, Shen JX, Li SG, Zhao H, Jiang Y, Li Y (2012) Comparison of initial efficacy between single and dual growing rods in treatment of early onset scoliosis. Chin Med J (Engl) 125:2862–2866
McElroy MJ, Shaner AC, Crawford TO, Thompson GH, Kadakia RV, Akbarnia BA, Skaggs DL, Emans JB, Sponseller PD (2011) Growing rods for scoliosis in spinal muscular atrophy: structural effects, complications, and hospital stays. Spine (Phila Pa 1976) 36:1305–1311. doi:10.1097/BRS.0b013e3182194937 View Article
Li QY, Zhang JG, Qiu GX, Wang YP, Shen JX, Zhao Y, Li SG, Yu B, Wang X, Weng XS (2010) Primary effect of dual growing rod technique for the treatment of severe scoliosis in young children. Chin Med J (Engl) 123:151–155
Sponseller PD, Yang JS, Thompson GH, McCarthy RE, Emans JB, Skaggs DL, Asher MA, Yazici M, Poe-Kochert C, Kostial P, Akbarnia BA (2009) Pelvic fixation of growing rods: comparison of constructs. Spine (Phila Pa 1976) 34:1706–1710. doi:10.1097/BRS.0b013e3181ab240e View Article
Akbarnia BA, Breakwell LM, Marks DS, McCarthy RE, Thompson AG, Canale SK, Kostial PN, Tambe A, Asher MA (2008) Dual growing rod technique followed for three to eleven years until final fusion: the effect of frequency of lengthening. Spine (Phila Pa 1976) 33:984–990. doi:10.1097/BRS.0b013e31816c8b4e View Article
Akbarnia BA, Marks DS, Boachie-Adjei O, Thompson AG, Asher MA (2005) Dual growing rod technique for the treatment of progressive early-onset scoliosis: a multicenter study. Spine (Phila Pa 1976) 30:S46–S57View Article
Jiang Y, Zhao Y, Wang YP, Qiu GX, Weng XS, Li Y (2011) Lung function after growing rod surgery for progressive early-onset scoliosis: a preliminary study. Chin Med J (Engl) 124:3858–3863
Grivas TB, Burwell RG, Purdue M, Webb JK, Moulton A (1991) A segmental analysis of thoracic shape in chest radiographs of children. Changes related to spinal level, age, sex, side and significance for lung growth and scoliosis. J Anat 178:21–38PubMed CentralPubMed
Emans JB, Ciarlo M, Callahan M, Zurakowski D (2005) Prediction of thoracic dimensions and spine length based on individual pelvic dimensions in children and adolescents: an age-independent, individualized standard for evaluation of outcome in early onset spinal deformity. Spine (Phila Pa 1976) 30:2824–2829View Article
Gold M, Dombek M, Miller PE, Emans JB, Glotzbecker MP (2014) Prediction of thoracic dimensions and spine length on the basis of individual pelvic dimensions: validation of the use of pelvic inlet width obtained by radiographs compared with computed tomography. Spine (Phila Pa 1976) 39:74–80. doi:10.1097/BRS.0000000000000036 View Article
Glotzbecker M, Johnston C, Miller P, Smith J, Perez-Grueso FS, Woon R, Flynn J, Gold M, Garg S, Redding G, Cahill P, Emans J (2014) Is there a relationship between thoracic dimensions and pulmonary function in early onset scoliosis? Spine (Phila Pa 1976). doi:10.1097/BRS.0000000000000449
Wang S, Zhang J, Qiu G, Wang Y, Weng X, Guo J (2014) One-stage posterior osteotomy with short segmental fusion and dual growing rod technique for severe rigid congenital scoliosis: the preliminary clinical outcomes of a hybrid technique. Spine (Phila Pa 1976) 39:E294–E299. doi:10.1097/BRS.0000000000000119 View Article
Noordeen HM, Shah SA, Elsebaie HB, Garrido E, Farooq N, Al-Mukhtar M (2011) In vivo distraction force and length measurements of growing rods: which factors influence the ability to lengthen? Spine (Phila Pa 1976) 36:2299–2303. doi:10.1097/BRS.0b013e31821b8e16 View Article
Sánchez Márquez JM, Sánchez Pérez-Grueso FJ, Fernández-Baíllo N, García Fernández A (2013) Growing rods in early-onset scoliosis. Do they really help to control the deformity and spinal and thoracic growth? Rev Esp Cir Ortop Traumatol 57:178–185. doi:10.1016/j.recot.2013.02.002 PubMed
Sabourin M, Jolivet E, Miladi L, Wicart P, Rampal V, Skalli W (2010) Three-dimensional stereoradiographic modeling of rib cage before and after spinal growing rod procedures in early-onset scoliosis. Clin Biomech (Bristol, Avon) 25:284–291. doi:10.1016/j.clinbiomech.2010.01.007 View Article

Titel: Dual growing rod treatment in early onset scoliosis: the effect of repeated lengthening surgeries on thoracic growth and dimensions
verfasst von: Zhi-jian Sun
Gui-xing Qiu
Yu Zhao
Shi-gong Guo
Jian-guo Zhang
Jian-xiong Shen
Yi-Peng Wang
Hong Zhao
Shu-gang Li
Publikationsdatum: 01.07.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 7/2015
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-014-3668-1

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders scheint das auf weibliche Kranke zuzutreffen, wie eine Studie zeigt.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Springer Medizin

Dual growing rod treatment in early onset scoliosis: the effect of repeated lengthening surgeries on thoracic growth and dimensions