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Conference Paper: Next generation of growth-sparing techniques: preliminary clinical results of a magnetically controlled growing rod in 14 patients

TitleNext generation of growth-sparing techniques: preliminary clinical results of a magnetically controlled growing rod in 14 patients
Authors
Issue Date2012
PublisherScoliosis Research Society.
Citation
The 47th Annual Meeting & Course of the Scoliosis Research Society (SRS), Chicago, IL., 5-8 September 2012. In Conference Program, 2012, p. 73-74, paper no. 33 How to Cite?
AbstractSUMMARY: Growth-sparing techniques are commonly used for the treatment of progressive EOS. The standard growing rod (GR) technique requires multiple surgeries for lengthening. The preliminary results of MCGR has shown the comparable outcomes to standard GR without the need for repeated surgery which can be expected to reduce the overall complication rate in GR surgery. INTRODUCTION: The growing rod (GR) technique for management of progressive Early-Onset Scoliosis (EOS) is a viable alternative but with a high complication rate attributed to frequent surgical lengthenings. The safety and efficacy of a non-invasive Magnetically Controlled Growing Rod (MCGR) has been previously reported in a porcine model. We are reporting the preliminary results of this technique in EOS. METHODS: Retrospective review of prospectively collected multi-center data. Only patients who underwent MCGR surgery and at least 3 subsequent spinal distractions were included in this preliminary review. Distractions were performed in clinic without anesthesia or analgesics. T1-T12 and T1-S1 height and the distraction distance inside the actuator were analyzed in addition to conventional clinical and radiographic data. RESULTS: Patients (N=14; 7 F and 7 M) had a mean age of 8y+10m (3y+6m to 12y+7m) and underwent a total of 14 index surgeries (SR: index single rod in 5 and DR: dual rod in 9) and 91 distractions. There were 5 idiopathic, 4 neuromuscular, 2 congenital, 2 syndromic and one NF. Mean follow-up (FU) was 10 months (5.8-18.2). Mean Cobb changed from 57° pre-op to 35° post-op and correction was maintained (35°) at latest FU. T1-T12 increased by 4 mm for SR and 10 mm for DR with mean monthly gain of 0.5 and 1.39, respectively. T1-S1 gain was 4 mm for SR and 17 mm for DR with mean monthly gain of 0.5 mm for SR and 2.35 mm for DR. The mean interval between index surgery and the first distraction was 66 days and thereafter was 43 days. Complications included one superficial infection in (SR), one prominent implant (DR) and minimal loss of initial distraction in three after index MCGR (all SR). Overall, partial loss of distraction was observed following 14 of the 91 distractions (one DR and 13 SR). This loss was regained in subsequent distractions. There was no neurologic deficit or implant failure. CONCLUSION: MCGR appears to be safe and provided adequate distraction similar to the standard GR technique without the need for repeated surgeries. DR patients had better initial curve correction and greater spinal height. No major complications were observed during the short follow-up period. The FDA has not cleared the drug and/or medical device for the use described in this presentation (i.e., the drug or medical device is being discussed for an ‘off label’ use).
DescriptionSession 3A - Early Onset Scoliosis: Paper no. 33
Persistent Identifierhttp://hdl.handle.net/10722/191681

 

DC FieldValueLanguage
dc.contributor.authorAkbarnia, BAen_US
dc.contributor.authorCheung, KMCen_US
dc.contributor.authorNoordeen, HHen_US
dc.contributor.authorElsebaie, HBen_US
dc.contributor.authorYazici, Men_US
dc.contributor.authorDannawi, Zen_US
dc.contributor.authorKabirian, Nen_US
dc.date.accessioned2013-10-15T07:17:40Z-
dc.date.available2013-10-15T07:17:40Z-
dc.date.issued2012en_US
dc.identifier.citationThe 47th Annual Meeting & Course of the Scoliosis Research Society (SRS), Chicago, IL., 5-8 September 2012. In Conference Program, 2012, p. 73-74, paper no. 33en_US
dc.identifier.urihttp://hdl.handle.net/10722/191681-
dc.descriptionSession 3A - Early Onset Scoliosis: Paper no. 33-
dc.description.abstractSUMMARY: Growth-sparing techniques are commonly used for the treatment of progressive EOS. The standard growing rod (GR) technique requires multiple surgeries for lengthening. The preliminary results of MCGR has shown the comparable outcomes to standard GR without the need for repeated surgery which can be expected to reduce the overall complication rate in GR surgery. INTRODUCTION: The growing rod (GR) technique for management of progressive Early-Onset Scoliosis (EOS) is a viable alternative but with a high complication rate attributed to frequent surgical lengthenings. The safety and efficacy of a non-invasive Magnetically Controlled Growing Rod (MCGR) has been previously reported in a porcine model. We are reporting the preliminary results of this technique in EOS. METHODS: Retrospective review of prospectively collected multi-center data. Only patients who underwent MCGR surgery and at least 3 subsequent spinal distractions were included in this preliminary review. Distractions were performed in clinic without anesthesia or analgesics. T1-T12 and T1-S1 height and the distraction distance inside the actuator were analyzed in addition to conventional clinical and radiographic data. RESULTS: Patients (N=14; 7 F and 7 M) had a mean age of 8y+10m (3y+6m to 12y+7m) and underwent a total of 14 index surgeries (SR: index single rod in 5 and DR: dual rod in 9) and 91 distractions. There were 5 idiopathic, 4 neuromuscular, 2 congenital, 2 syndromic and one NF. Mean follow-up (FU) was 10 months (5.8-18.2). Mean Cobb changed from 57° pre-op to 35° post-op and correction was maintained (35°) at latest FU. T1-T12 increased by 4 mm for SR and 10 mm for DR with mean monthly gain of 0.5 and 1.39, respectively. T1-S1 gain was 4 mm for SR and 17 mm for DR with mean monthly gain of 0.5 mm for SR and 2.35 mm for DR. The mean interval between index surgery and the first distraction was 66 days and thereafter was 43 days. Complications included one superficial infection in (SR), one prominent implant (DR) and minimal loss of initial distraction in three after index MCGR (all SR). Overall, partial loss of distraction was observed following 14 of the 91 distractions (one DR and 13 SR). This loss was regained in subsequent distractions. There was no neurologic deficit or implant failure. CONCLUSION: MCGR appears to be safe and provided adequate distraction similar to the standard GR technique without the need for repeated surgeries. DR patients had better initial curve correction and greater spinal height. No major complications were observed during the short follow-up period. The FDA has not cleared the drug and/or medical device for the use described in this presentation (i.e., the drug or medical device is being discussed for an ‘off label’ use).-
dc.languageengen_US
dc.publisherScoliosis Research Society.-
dc.relation.ispartof47th SRS Annual Meeting & Course 2012 Programen_US
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.titleNext generation of growth-sparing techniques: preliminary clinical results of a magnetically controlled growing rod in 14 patientsen_US
dc.typeConference_Paperen_US
dc.identifier.emailCheung, KMC: cheungmc@hku.hken_US
dc.identifier.authorityCheung, KMC=rp00387en_US
dc.description.naturepostprint-
dc.identifier.hkuros225825en_US
dc.identifier.spage73-
dc.identifier.epage74-
dc.publisher.placeUnited States-

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