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Growing rods may be effective for selected pediatric congenital spine deformities
Elsebai HB. J Ped Orthop. 2011. doi:10.1097/BPO.0b013e318202c1f0.
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Growing rod technique may be an alternative treatment for young children with progressive congenital spine deformities. The procedure improved the deformity, spinal growth and the space available for the lung, according to this retrospective study.
Hazeem B. Elsebai, MD, and colleagues at the Hacettepe University in Ankara, Turkey, followed 19 patients who are part of the international, multicenter Growing Spine Study Group. All patients had progressive, congenital spinal deformities and underwent growing rod surgery with a minimum of 2-years follow-up. Mean follow-up was 4 years.
The investigators analyzed the following data:
- age at initial surgery;
- number of abnormal vertebrae per patient;
- number of lengthenings postoperatively;
- Cobb angle of the major curve preoperatively, at immediate postoperative follow-up and at last follow-up;
- T1-S1 length;
- space available for the lung (SAL);
- length of follow-up; and complications.
Analysis showed that mean age at surgery was 6.9 years. The mean number of affected vertebrae per patient was 5.2. Per patient, the mean number of lengthenings was 4.2. The major Cobb angle improved from 66· preoperatively to 45· at immediate postoperative follow-up and 47· at the last follow-up, the authors wrote.
Postoperatively, T1-S1 length was 268.3 mm. This increased to 315.4 mm at last follow-up. The mean T1-S1 length increase was 11.7 mm per year. The SAL ratio was 0.81 preoperatively, which increased to 0.94 at latest follow-up.
Five patients have undergone final fusion. Fourteen patients are still undergoing treatment. Eight patients have had complications. In 100 procedures, there were 11 implant-related complications, two pulmonary complications and one postoperative infection.