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Minimizing complications with single submuscular growing rods: a review of technique and results on 88 patients with minimum two-year follow-up.
MedLine Citation:
PMID:  21102301     Owner:  NLM     Status:  In-Process    
STUDY DESIGN: Retrospective clinical and radiologic review of consecutive series of patients treated with single submuscular growing rods from a single center with a minimum of 2-year follow-up.
OBJECTIVES: To describe the surgical technique and methods used to minimize complications and to report on the outcomes of a large consecutive series of patients treated with single submuscular growing rods for scoliosis in the immature spine from a single center.
SUMMARY OF BACKGROUND DATA: Previous studies have reported on the safety and efficacy of single and dual growing-rod constructs; however, these studies have been of small patient numbers with varying results.
METHODS: Between 1999 and 2007, 88 patients underwent the insertion of a single, submuscular growing-rod construct for scoliosis. A clinical and radiologic review of these 88 consecutive patients with a minimum of 2-year follow-up was conducted. Diagnoses include idiopathic, neuromuscular, syndromic, and congenital. Data include Cobb angle measurements, T1-S1 heights, number, and frequency of lengthening as well as complications.
RESULTS: The patients underwent single submuscular growing-rod insertion at an average age of 7.0 years. The mean follow-up period was 42 months. Twenty-eight patients had a simultaneous apical fusion. Growing-rod lengthening was performed on an average at 9-month intervals. The average initial Cobb angle was 73° (range: 40-117) and improved to 44° (range: 9-90) at final follow-up. T1-S1 height gain was 3.37 cm; this translates to 1.04 cm growth/yr. No significant difference was noted between those who had undergone apical fusion and those without. Complications noted in this series include 8 incidences of superficial infection and 3 of deep infection, proximal junctional kyphosis in 2 patients requiring early fusion, 31 rod fractures, 10 cases of proximal anchor failure, and 6 distal anchor failures. Thirty patients within study group have reached definitive fusion.
CONCLUSION: Favorable outcomes have been demonstrated in this large single-center series of growing-rod constructs used to treat scoliosis in the growing spine. Their safety and efficacy in controlling spinal deformity and allowing spinal growth along with an acceptable rate of complications would support the continued use of single growing-rod constructs as a scoliosis management option.
Najma Farooq; Enrique Garrido; Farhaan Altaf; Joanne Dartnell; Suken A Shah; Stewart K Tucker; Hilali Noordeen
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Spine     Volume:  35     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2252-8     Citation Subset:  IM    
Department of Spinal Surgery, Great Ormond Street Hospital, London, United Kingdom.
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