More osteotomies during fusion may lead to more curve correction in early onset scoliosis
Click Here to Manage Email Alerts
Key takeaways:
- Early onset scoliosis patients with more osteotomies during conversion to spinal fusion had more curve correction.
- There were similar complication rates for patients who did vs. did not have osteotomies.
Results showed more posterior column osteotomies performed at the time of conversion from growing rods spinal fusion may lead to more curve correction without increasing complications in patients with early onset scoliosis.
“I hope [these results] make surgeons more willing to do osteotomies,” Tyler Tetreault, MD, pediatric orthopedic surgeon in the Jackie and Gene Autry Orthopedic Center at Children’s Hospital Los Angeles, told Healio about results presented at the Scoliosis Research Society Annual Meeting. “Posterior column osteotomies can provide a better result, and the downsides of blood loss and surgical time will improve the more that you do it.”
Using data from the Pediatric Spine Study Group Registry, Tetreault and colleagues retrospectively categorized 832 pediatric patients with early onset scoliosis undergoing conversion from growing rod instrumentation to posterior spinal fusion into groups based on whether they received posterior column osteotomies (n = 175) at the time of fusion.
“When we looked at the two groups as a whole, we found that there was no change in the correction achieved at the time of fusion for those that did or did not have the osteotomies performed,” Tetreault said. “In general, that correction is small. It is only about 14° to 16° of curve correction during that time, which is significantly less than those that have a primary spinal fusion that have not had the growing rods in place.”
However, Tetreault said patients who underwent more osteotomies experienced more curve correction, with an average curve correction of 12.5° among patients who received four or fewer osteotomies vs. an average curve correction of 27° among patients who received nine or more osteotomies.
Although each osteotomy performed added approximately 15 mL of blood loss and 12 minutes of surgical time, Tetreault said the osteotomy and no osteotomy groups had a similar rate of complications.
“While the surgery itself might be a little bit more involved, the overall complication rate is no different. In particular, spinal cord signaling changes and rates of dural tear were not higher in the osteotomy group,” Tetreault said.
Collapse
Tetreault T, et al. Paper 116. Presented at: Scoliosis Research Society Annual Meeting; Sept. 11-14, 2024; Barcelona, Spain.
Click Here to Manage Email Alerts