Rib-hook construct may be safe, effective treatment for pediatric hyperkyphosis, kyphoscoliosis
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PHOENIX — Use of a rib-hook construct for hyperkyphosis or kyphoscoliosis may be a safe and effective treatment among pediatric patients, according to results presented at the Orthopaedic Research Society Annual Meeting.
“This is significant because it may be a paradigm shift in the way we treat children with complicated 3-dimensional spinal deformity,” Daniel Bonthius, BA, said in his presentation. “So far, the focus of our research has been on pediatric patients, but this may be applicable in adult cases as well.”
Bonthius and colleagues retrospectively reviewed 23 pediatric patients with kyphoscoliosis or hyperkyphosis without scoliosis treated with the rib-hook construct to examine radiographic outcomes, complication rates, procedure times and blood loss.
Bonthius noted patients treated with the rib-hook construct had better sagittal plane correction and coronal plane correction similar to patients who received groin rods anchored directly to the spine with pedicle screws.
“For complications, we found a reduced complication rate of the rib construct compared to groin rods with pedicle screws in a similar patient population of kyphoscoliotic patients,” Bonthius said.
Prior to the retrospective study, Bonthius noted they performed an ex vivo biomechanical study that compared traditional pedicle screw proximal fixation to the rib-hook construct “in terms of proximal fixation strength and stiffness when loaded with a hyperkyphotic bending force” in a porcine model.
“We found proximal fixation failure with pedicle screw pull-out being the failure mechanism in all of our pedicle screw specimens tested,” Bonthius said. “By contrast, we saw no failure of the rib construct, despite reaching the maximum force and deflection angle that could be applied by the mechanical testing system.” – by Casey Tingle
Reference:
Bonthius D, et al. Paper 224. Presented at: Orthopaedic Research Society Annual Meeting; Feb. 8-11, 2020; Phoenix.
Disclosure: Bonthius reports no relevant financial disclosures.