Hybrid Growing Rod Technique of Osteotomy With Short Fusion and Spinal Distraction: An Alternative Solution for Long-Spanned Congenital Scoliosis. Issue 10 (15th May 2019)

• Record Type: Journal Article
• Authors: Sun, Xu; Xu, Liang; Chen, Zhonghui; Shi, Benlong; Chen, Xi; Li, Song; Du, Changzhi; Zhou, Qingshuang; Qiu, Yong; Zhu, Zezhang
• Is Part Of: Spine. Volume 44:Issue 10(2019)
• Publication Date: 2019-05-15
• Subjects: congenital scoliosis -- growing rod -- hybrid technique -- osteotomy; Spine -- Abnormalities -- Periodicals; Spine -- Diseases -- Periodicals; Spine -- Surgery -- Periodicals; 616.73005
• DOI: 10.1097/BRS.0000000000002933
• Languages: English
• ISSNs: 0362-2436

Abstract

Abstract : Study Design: Retrospective study. Objective: The current study aimed to evaluate the effectiveness of the hybrid growing rod (GR) technique for the treatment of young children with congenital scoliosis (CS). Summary of Background Data: Congenital vertebral anomalies within long-spanned kyphoscoliosis were difficult to be managed by either definitive spinal fusion or standard GR technique. Hybrid technique of one-stage posterior osteotomy with short fusion and GR distraction was proposed in previous studies. There is, however, paucity of data regarding its effectiveness. Methods: Thirteen patients (mean age, 5.4 ± 2.0 yr) who had undergone hybrid GR treatment were retrospectively reviewed, including 8 patients treated with single GR and 5 patients with dual GR. All of their radiographic data were measured, and surgical complications were recorded. Results: On average, the current cohort had 4.1 ± 1.7 lengthening procedures. After the index surgery, the major curve improved remarkably from 86.4° ± 11.9° to 37.3° ± 12.4° ( P < 0.001). The global kyphosis significantly decreased from 66.8° ± 16.1° to 33.3° ± 3.5° postoperatively. Both value remained steady during follow-up. There were no significant difference between single GR and dual GR groups in terms of the coronal deformity correction, whereas correction loss of global kyphosis in single GR group was significantly higher than that in dual GR group ( P = 0.039). After the index surgery, T1-S1 height averagely gained 4.4 ± 0.8 cm and it grew at an average rate of 1.31 ± 0.24 cm/yr during the follow-up. Two complications were identified in two patients, including one with rod fracture and one with proximal junctional kyphosis. Conclusion: The hybrid GR technique was effective in correcting spinal deformity and allowing continuous spinal growth. The optimal indications were young children with apical vertebrae anomalies and a long-spanned kyphoscoliosis. Level of Evidence: 3 Abstract : Congenital vertebral anomalies within long-spanned kyphoscoliosis in young children were difficult to be managed by either definitive spinal fusion or standard growing rod (GR) technique. The current study demonstrated that hybrid technique of one-stage posterior osteotomy with short fusion and GR distraction was effective in improving spinal deformity correction and decreasing complications.