Spine (Phila Pa 1976). 2014 May 12. [Epub ahead of print]
Yoon WW, Sedra F, Shah S, Wallis C, Muntoni F, Noordeen H.
To determine whether there is improvement in pulmonary function in children with early onset scoliosis (EOS) using magnetic growth rods (MGR).
SUMMARY OF BACKGROUND DATA:
EOS deformities have large impacts on lung function and volumes. Deterioration of pulmonary function in scoliosis is multifactorial including severity, location of apex vertebra and medical co-morbidities.
MGR insertion has benefits including reduction in operative procedures with repeated anesthetics, cost effectiveness and minimizing surgical and psychological distress. Pulmonary function tests (PFT) provide objective and quantitative information about functional impairment caused by scoliosis. This is the first study looking at magnetic growth rod lengthening and changes in pulmonary function over minimum of 2.2 Years (Y).
Six cases of EOS secondary to neuromuscular disease (NMD) were identified. Mean age at diagnosis was 2.8 Y (2.1-4.9), mean age at surgery was 7.5 Y (5-10) and mean follow-up was 2.5 Y (2.2-2.8). PFT (FVC + FEV1 both %Predicted) were measured pre and post insertion of MGR and at every lengthening clinic subsequently for a minimum 2Y. Coronal and sagittal Cobb angles were measured pre and postoperatively as were length extension of growth rods. All except one patient had dual magnetic growth rods inserted (the other had a single rod). Lengthening was commenced and data collected at 6 monthly intervals.
Average correction for Cobb angles were 34±18° and 36±15° for coronal and sagittal Cobb angles respectively. Mean lengthening achieved was 24.9mm. Mean improvement in postoperative FVC and FEV1 was 14.1% and 17.2% respectively. There was significant difference between the median preoperative and postoperative Cobb angle, p = 0.028.
This study demonstrates early intervention using MGR in patients with early onset scoliosis is associated with significant improvement in postoperative PFT’s; and significant improvement in deformity correction with use of MGR with added benefits of reduction in repeat anesthesia, reduction in surgical and psychological distress and cost effectiveness.
PMID: 24825149 [PubMed – as supplied by publisher]
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