Low-density constructs achieved reliable correction for pediatric neuromuscular scoliosis
Click Here to Manage Email Alerts
Key takeaways:
- Low-density vs. high-density spinal fusion constructs achieve similar curve correction and outcomes for pediatric patients with neuromuscular scoliosis.
- Use of low-density implants may reduce OR times and costs.
Presented results showed low-density spinal fusion constructs achieved comparable curve correction with reduced OR times compared with higher-density constructs for pediatric patients with neuromuscular scoliosis.
“There has been a lot of work looking at implant density in the idiopathic scoliosis population, but no one had looked at it for neuromuscular patients,” Patrick Thornley, MD, MSc, FRCSC, a pediatric spine surgeon at Nemours Children’s Health, told Healio.
Thornley and colleagues from the Harms Study Group retrospectively reviewed data from their prospective pediatric scoliosis database to assess the impact of implant density on curve correction for pediatric patients with neuromuscular scoliosis.
They reviewed data from 235 pediatric patients who underwent upper thoracic to pelvic posterior spinal fusion with a minimum follow-up of 2 years.
Among the cohort, 56 patients received low-density constructs (average of 1.3 screws per level); 84 patients received medium-density constructs (average of 1.6 screws per level); and 95 patients received high-density constructs (average of 1.9 screws per level).
Primary outcomes were postoperative coronal and sagittal plane curve correction and pelvic obliquity. Other outcomes included functional outcomes, complications and OR time.
Thornley and colleagues found no differences in curve correction, pelvic obliquity, functional outcomes or complications between the three groups.
“While we didn't explicitly look at [costs], we know the more screws you use, the higher the cost,” Thornley said.
He noted patients who underwent surgery with high-density implants had a significant increase in OR time (approximately 100 minutes more) compared with patients who received low-density implants.
“That's a significant amount of resources, as well as strain on the patient's bodies during the surgery,” Thornley added.
Thornley concluded surgeons should feel comfortable using low-density implants in pediatric patients with neuromuscular scoliosis or cerebral palsy.
Future directions should assess patients with C-shaped vs. S-shaped curves with a longer follow-up, he added.
Collapse
Thornley P, et al. Paper 19. Presented at: Combined EPOSNA Meeting; May 8-11, 2024; National Harbor, Maryland.
Click Here to Manage Email Alerts