Key result
GRSPSS is linked to a ~73% correction in Cobb angle and increased spinal height.
Why the study?
Conventional growing rods for early-onset scoliosis require multiple lengthening surgeries under general anesthesia, leading to high costs and potential negative psychosocial outcomes.
Does the growing rods with sliding pedicle screw system (GRSPSS) safely and effectively correct spinal deformity and allow spinal growth in patients with early-onset scoliosis?
Cohort (n=18)
No
Does the growing rods with sliding pedicle screw system (GRSPSS) safely and effectively correct spinal deformity and allow spinal growth in patients with early-onset scoliosis?
Absolute Event Rate: 15.5% vs 56.6%
p-value: p=< 0.0001
The GRSPSS safely and effectively corrects spinal deformity and facilitates spinal growth without the need for repeated lengthening operations in early-onset scoliosis.
May support GRSPSS for early-onset scoliosis without repeated lengthening; leaves open confirmation in randomized trials.
Background: The growing rod (GR) technique is a viable alternative for the current non-fusion treatment of early-onset scoliosis (EOS). However, conventional GRs are lengthened to allow for spinal growth, which requires multiple surgeries under general anesthesia in association with high cost and potentially negative psychosocial outcomes. Methods: In this study, growing rods with a sliding pedicle screw system (GRSPSS) was developed for the treatment of EOS without need of repeated operative lengthening. A retrospective review of clinical data on EOS patients who were treated with GRSPSS system was performed to evaluate the safety and efficacy of this technique. Results: 33 patients received GRSPSS instrumentation and 18 of them were finally included with more than 5-year follow-up data. There were 10 girls and 8 boys with a mean age of 9 years old. The mean preoperative curve (56.6 degrees) was corrected to 15.5 degrees at the 4-week follow-up. This magnitude of correction maintained at the 5-year follow-up. T1-S1 spinal height gained an average of 42 mm on measurement from postoperative to the final follow-up period. Complications included transient neurological deficit in one case and skin infection at one end of the rods in three cases during the early-postoperative period. Two patients required minimally invasive revision surgery because of shoulder imbalance. Rod breakage occurred in two cases.Conclusions: The GRSPSS can safely and effectively correct spinal deformity at a 5-year follow-up. This new instrumentation may be a promising approach for facilitating spinal growth without repeated lengthening operations.
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Ouyang et al. (2021) conducted a cohort in Early-onset scoliosis (n=18). Growing rods with a sliding pedicle screw system (GRSPSS) vs. Preoperative baseline was evaluated on Cobb angle at last follow-up (p=< 0.0001). Treatment with the GRSPSS significantly corrected the mean preoperative Cobb angle from 56.6 degrees to 15.5 degrees and increased T1-S1 spinal height by an average of 42 mm at a minimum 5-year follow-up.
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