Open Access, Peer-reviewed
pISSN 2093-4378
eISSN 2093-4386
    J Korean Soc Spine Surg. 2013 Mar;20(1):8-15. Korean.
    Published online Mar 31, 2013.
    https://doi.org/10.4184/jkss.2013.20.1.8
    © Copyright 2013 Korean Society of Spine Surgery
    Original Article

    Results of Dual Growing Rods Treatment for Progressive Pediatric Spinal Deformity

    Hyoung Bok Kim, M.D., Hyon-Su Chong, M.D., Eun Su Moon, M.D., Hwan Mo Lee, M.D., Seong Hwan Moon, M.D., Jin Oh Park, M.D., Jea Ho Yang, M.D. and Hak-Sun Kim, M.D.
      • Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea.
    • Corresponding author: Hak-Sun Kim, M.D. Department of Orthopaedic Surgery, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul 135-720, Korea. TEL: 82-2-2019-3411, FAX: 82-2-573-5393, Email: haksunkim@yuhs.ac
    Received March 27, 2012; Revised May 21, 2012; Accepted September 11, 2012.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Study Design

    A prospective study.

    Objectives

    To report the results of new designed dual growing rods system for progressive pediatric spinal deformity.

    Summary of Literature Review

    The current expandable spinal implant system appears effective in controlling progressive pediatric spinal deformity, allowing for spinal growth. However, there was no report concerning the growing rod in Korea.

    Materials and Methods

    Between 2010 and 2011, seven pediatric patients, who had a minimum of 1year follow-up, had undergone surgery for spinal deformity correction with a dual growing rods technique. We analyzed the demographic and radiologic data, including height, weight, age at surgery, diagnosis, number of lengthening, Cobb's angle of the major curve, thoracic kyphosis angle, lumbar lordosis angle, T1-S1 length, instrumented segment length, and complications, from the preoperative period to the last follow up period.

    Results

    Four male and three female patients with 5 neuromuscular scoliosis, 1 idiopathic juvenile osteoporosis and 1 spondyloepiphyseal dysplasia had underwent corrective surgery with dual growing rods. The mean age at the initial surgery was 11.6 years (7-13.8). The mean follow-up duration was 19.3 months (12-24), and the mean lengthening procedure time was 2.8 (2-4) for every patient. Cobb's angle of scoliosis curve was corrected from preoperative 80.2°(55-136) to 37.6° (15-81) on the last follow-up. Thoracic kyphosis angle and lumbar lordosis angle were changed from preoperative 48.7°(12-101) and 38.3°(9-72) to 44.5°(12-75) and 18.8°(1-46) on the last follow-up, respectively. Growth length during the follow-up period was measured as instrumented segment is 46 mm (33-59) and T1-S1 segment is 82 mm (66-98). Complications, such as breakage of rod in 3 cases and soft tissue infection in 1 case, occurred during the follow-up period.

    Conclusions

    New designed dual growing rods system for pediatric patients with progressive spinal deformity is an effective and relatively safe method because of adequate correction and acceptable rate of complications.

    Keywords
    Spinal deformity; Scoliosis; Growing rods

    Figures

    Fig. 1
    This diagram shows three parts compositions of growing rods system. (A) conventional rod for lumbar contouring, (B) Growing tube, (C) Growing rod for thoraco-lumbar contouring.

    Fig. 2
    This clinical photo shows that there were two separated incisions for pedicle screw insertion and intramuscular rod placement.

    Fig. 3
    Serial radiographs of 7 years male patients with neuromuscular scoliosis due to lipomeningocele. (A) Preoperative whole spine PA view. (B) Whole spine PA view after primary surgery. (C) Whole spine PA view after first lengthening procedure for growing rods. (D) Whole spine PA view shows last follow up after fourth lengthening procedure.

    Fig. 4
    Serial radiographs of 10 years 9 month male patients with spondyloepiphyseal dysplasia. (A) Preoperative whole spine Lateral view. (B) Whole spine lateral view after primary surgery. (C) Whole spine lateral view after first lengthening procedure for growing rods. (D) Whole spine lateral view after second lengthening procedure for growing rods. (E) Whole spine PA view shows rod breakage of left distal lumbar rod(arrow) during follow up after second lengthening procedure for growing rods.

    Tables

    Table 1
    Demographics and Surgical Data for All Patients

    Table 2
    Clinical and Radiologic Data for All patients

    References

      1. Akbarnia BA, Emans JB. Complications of growth-sparing surgery in early onset scoliosis. Spine (Phila Pa 1976) 2010;35:2193–2204.
      1. Vitale MG, Gomez JA, Matsumoto H, Roye DP Jr. Variability of expert opinion in treatment of early-onset scoliosis. Clin Orthop Relat Res 2011;469:1317–1322.
      1. Mehta M, Morel G. The non-operative treatment of infantile idiopathic scoliosis. In: Zorab PA, Siezler D, editors. Scoliosis. 1st ed. London: Academic Press; 1980. pp. 71-84.
      1. Winter RB, Moe JH. The results of spinal arthrodesis for congenital spinal deformity in patients younger than five years old. J Bone Joint Surg Am 1982;64:419–432.
      1. Davies G, Reid L. Effect of scoliosis on growth of alveoli and pulmonary arteries and on right ventricle. Arch Dis Child 1971;46:623–632.
      1. Dunnill MS. Postnatal growth of the lung. Thorax 1962;17:329–333.
      1. Emery JL, Mithal A. The number of alveoli in the terminal respiratory unit of man during late intrauterine life and childhood. Arch Dis Child 1960;35:544–547.
      1. Thompson GH, Akbarnia BA, Kostial P, et al. Comparison of single and dual growing rod techniques followed through definitive surgery: a preliminary study. Spine (Phila Pa 1976) 2005;30:2039–2044.
      1. Elsebai HB, Yazici M, Thompson GH, et al. Safety and efficacy of growing rod technique for pediatric congenital spinal deformities. J Pediatr Orthop 2011;31:1–5.
      1. Kim JY, Moon ES, Chong HS, Lee SJ, Kim HS. Comparison of mechanical property of conventional rods versus growing rods for pediatric early onset scoliosis. J Korean Soc Spine Surg 2010;17:177–183.
      1. Harrington PR. Treatment of scoliosis. Correction and internal fixation by spine instrumentation. J Bone Joint Surg Am 1962;44:591–610.
      1. Goldberg CJ, Moore DP, Fogarty EE, Dowling FE. Long-term results from in situ fusion for congenital vertebral deformity. Spine (Phila Pa 1976) 2002;27:619–628.
      1. Karol LA, Johnston C, Mladenov K, Schochet P, Walters P, Browne RH. Pulmonary function following early thoracic fusion in non-neuromuscular scoliosis. J Bone Joint Surg Am 2008;90:1272–1281.
      1. Dubousset J, Herring JA, Shufflebarger H. The crankshaft phenomenon. J Pediatr Orthop 1989;9:541–550.
      1. Shufflebarger HL, Clark CE. Prevention of the crankshaft phenomenon. Spine (Phila Pa 1976) 1991;16 8 Suppl:S409–S411.
      1. Mardjetko SM, Hammerberg KW, Lubicky JP, Fister JS. The Luque trolley revisited: review of nine cases requiring revision. Spine (Phila Pa 1976) 1992;17:582–589.
      1. McCarthy RE, Sucato D, Turner JL, Zhang H, Henson MA, McCarthy K. Shilla growing rods in a caprine animal model: a pilot study. Clin Orthop Relat Res 2010;468:705–710.
      1. Thompson GH, Akbarnia BA, Campbell RM Jr. Growing rod techniques in early-onset scoliosis. J Pediatr Orthop 2007;27:354–361.
      1. Campbell RM, Smith MD, Hell-Vocke AK. Expansion thoracoplasty: the surgical technique of opening-wedge thoracostomy. Surgical technique. J Bone Joint Surg Am 2004;86-A Suppl 1:51–64.
      1. Mineiro J, Weinstein S. Subcutaneous rodding for progressive spinal curvatures: early results. J Pediatr Orthop 2002;22:290–295.
      1. Bess S, Akbarnia BA, Thompson GH, et al. Complications of growing-rod treatment for early-onset scoliosis: analysis of one hundred and forty patients. J Bone Joint Surg Am 2010;92:2533–2543.
      1. Akbarnia BA, Marks DS, Boachie-Adjei O, Thompson AG, Asher MA. Dual growing rod technique for the treatment of progressive early-onset scoliosis: a multicenter study. Spine (Phila Pa 1976) 2005;30 17 Suppl:S46–S57.
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    MeSH Terms
    Animals
    Congenital Abnormalities
    Female
    Follow-Up Studies
    Humans
    Kyphosis
    Lordosis
    Male
    Osteochondrodysplasias
    Osteoporosis
    Preoperative Period
    Prospective Studies
    Scoliosis
    Soft Tissue Infections
    Metrics
    Share
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