Scholarlink

Introduction <p>Few studies directly compare the efficacy of magnetic-controlled and traditional growing rods for early onset scoliosis (EOS) treatment from pre-implantation to definitive fusion or final lengthening. We hypothesize that TGR is more efficient than MCGR in achieving more spine length and curve correction but at the cost of more complications. We also hypothesize that patient-reported outcomes and pulmonary function are minimally changed after completion of treatment.</p> Methods <p>All patients treated at one institution between 2010 and 2022 who graduated from growth-sparing treatment and had undergone definitive fusion or were being observed with retained implants were evaluated. T1-T12 and T1-S1 lengths and curve magnitude were recorded at 3 time points on coronal films: pre-op, prior to definitive fusion or after final lengthening, and post-definitive fusion or last observation. EOSQ-24 scores, PFTs, and complications were collected.</p> Results <p>Fifty-one patients (27 MCGR, 24 TGR) had complete graduation radiographs. Age of insertion was no different (MCGR- age 7 vs. TGR—6.5, p = 0.14) or at removal (MCGR—11.7 vs TGR—11.3, <i>p</i> = 0.48). MCGR patients had smaller initial curves (81 vs 89° <i>p</i> = .02), which remained smaller (32° vs TGR 50°, <i>p</i> &lt; .001) after definitive fusion. T1-12 length was initially shorter for TGR (14.8 vs 16.3&#xa0;cm, <i>p</i> = .05) but no different at pre-definitive due to more effective TGR length gain (TGR &gt; MCGR 5.8 vs 3.6&#xa0;cm <i>p</i> = .006). Similarly, TGR gained more T1-S1 length than MCGR (8.9 vs 6.1&#xa0;cm, <i>p</i> = .01). Overall TGR patients gained greater length but at the cost of more complications per patient than MCGR (2.4 vs 1.5 <i>p</i> = 0.0035) and more UPRORs (<i>p</i> = .04). TGR patients gained greater absolute and % predicted PFT volumes compared to preoperative values which did not occur in the MCGR cohort. EOSQ-24 scores for MCGR improved in several domains.</p> Conclusion <p>Deformity correction was primarily achieved at initial implantation surgery for both techniques, though MCGR patients achieved even smaller curves after definitive fusion compared to TGR. TGR lengthened more effectively than MCGR but with more complications and UPRORs. PFTs were improved for TGR patients but not for MCGR, while EOSQ scores in the MCGR cohort were modestly improved.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Traditional versus magnetic-controlled growth rods for early onset scoliosis treatment: radiographic, pulmonary, and quality-of-life outcomes at graduation

  • 期刊论文

  • 发表日期：

    2025年10月24日

查看全文
  • Charles E. Johnston,
  • Tiffany Thompson,
  • Amareesa Robinson,
  • Rikki Koehler

摘要

Introduction

Few studies directly compare the efficacy of magnetic-controlled and traditional growing rods for early onset scoliosis (EOS) treatment from pre-implantation to definitive fusion or final lengthening. We hypothesize that TGR is more efficient than MCGR in achieving more spine length and curve correction but at the cost of more complications. We also hypothesize that patient-reported outcomes and pulmonary function are minimally changed after completion of treatment.

Methods

All patients treated at one institution between 2010 and 2022 who graduated from growth-sparing treatment and had undergone definitive fusion or were being observed with retained implants were evaluated. T1-T12 and T1-S1 lengths and curve magnitude were recorded at 3 time points on coronal films: pre-op, prior to definitive fusion or after final lengthening, and post-definitive fusion or last observation. EOSQ-24 scores, PFTs, and complications were collected.

Results

Fifty-one patients (27 MCGR, 24 TGR) had complete graduation radiographs. Age of insertion was no different (MCGR- age 7 vs. TGR—6.5, p = 0.14) or at removal (MCGR—11.7 vs TGR—11.3, p = 0.48). MCGR patients had smaller initial curves (81 vs 89° p = .02), which remained smaller (32° vs TGR 50°, p < .001) after definitive fusion. T1-12 length was initially shorter for TGR (14.8 vs 16.3 cm, p = .05) but no different at pre-definitive due to more effective TGR length gain (TGR > MCGR 5.8 vs 3.6 cm p = .006). Similarly, TGR gained more T1-S1 length than MCGR (8.9 vs 6.1 cm, p = .01). Overall TGR patients gained greater length but at the cost of more complications per patient than MCGR (2.4 vs 1.5 p = 0.0035) and more UPRORs (p = .04). TGR patients gained greater absolute and % predicted PFT volumes compared to preoperative values which did not occur in the MCGR cohort. EOSQ-24 scores for MCGR improved in several domains.

Conclusion

Deformity correction was primarily achieved at initial implantation surgery for both techniques, though MCGR patients achieved even smaller curves after definitive fusion compared to TGR. TGR lengthened more effectively than MCGR but with more complications and UPRORs. PFTs were improved for TGR patients but not for MCGR, while EOSQ scores in the MCGR cohort were modestly improved.