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Outcomes after completing growth-friendly surgical treatment for early-onset scoliosis in patients with skeletal dysplasia.
Saarinen, Antti J; Sponseller, Paul; Thompson, George H; White, Klane K; Emans, John; Cahill, Patrick J; Hwang, Steven; Helenius, Ilkka.
Afiliación
  • Saarinen AJ; Department of Paediatric Orthopaedic Surgery, University of Turku and Turku University Hospital, Turku, Finland.
  • Sponseller P; Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland, USA.
  • Thompson GH; Division of Pediatric Orthopaedic Surgery, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, Ohio, USA.
  • White KK; Department of Orthopaedics and Sports Medicine, Children's Hospital Colorado, Aurora, Colorado, USA.
  • Emans J; Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts, USA.
  • Cahill PJ; Department of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
  • Hwang S; Department of Neurosurgery, Shriners Hospitals for Children, Philadelphia, Pennsylvania, USA.
  • Helenius I; Department of Paediatric Orthopaedic Surgery, University of Turku and Turku University Hospital, Turku, Finland.
Bone Joint J ; 106-B(6): 596-602, 2024 Jun 01.
Article en En | MEDLINE | ID: mdl-38821501
ABSTRACT

Aims:

The aim of this study was to compare outcomes after growth-friendly treatment for early-onset scoliosis (EOS) between patients with skeletal dysplasias versus those with other syndromes.

Methods:

We retrospectively identified 20 patients with skeletal dysplasias and 292 with other syndromes (control group) who had completed surgical growth-friendly EOS treatment between 1 January 2000 and 31 December 2018. We compared radiological parameters, complications, and health-related quality of life (HRQoL) at mean follow-up of 8.6 years (SD 3.3) in the dysplasia group and 6.6 years (SD 2.6) in the control group.

Results:

Mean major curve correction per patient did not differ significantly between the dysplasia group (43%) and the control group (28%; p = 0.087). Mean annual spinal height increase was less in the dysplasia group (9.3 mm (SD 5.1) than in the control group (16 mm (SD 9.2); p < 0.001). Mean annual spinal growth adjusted to patient preoperative standing height during the distraction period was 11% in the dysplasia group and 14% in the control group (p = 0.070). The complication rate was 1.6 times higher (95% confidence interval (CI) 1.3 to 2.0) in the dysplasia group. The following complications were more frequent in the dysplasia group neurological injury (rate ratio (RR) 5.1 (95% CI 2.3 to 11)), deep surgical site infection (RR 2.2 (95% CI 1.2 to 4.1)), implant-related complications (RR 2.0 (95% CI 1.5 to 2.7)), and unplanned revision (RR 1.8 (95% CI 1.3 to 2.5)). Final fusion did not provide additional spinal height compared with watchful waiting (p = 0.054). There were no significant differences in HRQoL scores between the groups.

Conclusion:

After growth-friendly EOS treatment, patients with skeletal dysplasias experienced a higher incidence of complications compared to those with other syndromes. Surgical growth-friendly treatment for skeletal dysplasia-associated EOS should be reserved for patients with severe, progressive deformities that are refractory to nonoperative treatment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calidad de Vida / Escoliosis / Enfermedades del Desarrollo Óseo Límite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Bone Joint J Año: 2024 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calidad de Vida / Escoliosis / Enfermedades del Desarrollo Óseo Límite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Bone Joint J Año: 2024 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Reino Unido