An Operation for Stapling Vertebral Bodies in Congenital Scoliosis

Smith, Alan DeFOREST; Lackum, William H. Von; Wylie, Robert H.

doi:10.2106/00004623-195436020-00011

Cited by 97 publications

(28 citation statements)

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“…In 1954, Smith et al described the stapling of vertebral bodies in three patients with congenital scoliosis. 8 The procedure was able to halt progression of the curve over the treated levels; however, there was no curve correction and compensatory curves developed above and below the treated levels. 8 Roaf et al described the use of spinal hemiepiphysiodesis in 188 patients with paralytic, congenital, and idiopathic scoliosis.…”

Section: Discussionmentioning

confidence: 95%

“…8 The procedure was able to halt progression of the curve over the treated levels; however, there was no curve correction and compensatory curves developed above and below the treated levels. 8 Roaf et al described the use of spinal hemiepiphysiodesis in 188 patients with paralytic, congenital, and idiopathic scoliosis. 21 This "hemifusion" was attempted to arrest growth on the convex side of the curve, allowing the concave side to grow and reduce deformity.…”

Section: Discussionmentioning

confidence: 95%

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Multilevel Spinal Growth Modulation With an Anterolateral Flexible Tether in an Immature Bovine Model

Newton

Faro²,

Farnsworth³

et al. 2005

Spine

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 95%

Multilevel Spinal Growth Modulation With an Anterolateral Flexible Tether in an Immature Bovine Model

Newton

Faro²,

Farnsworth³

et al. 2005

Spine

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“…Treatment options by which satisfying results are obtained in these kind of spinal deformities are rather limited. Since 1922, many attempts at arresting progressive growth of the convex scoliotic curve by convex hemi-epiphysiodesis have been documented, with varying results [10,14,16].…”

Section: Introductionmentioning

confidence: 99%

Hemi-epiphysiodesis for unclassified congenital scoliosis: immediate results and mid-term follow-up

2002

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Complex spinal anomalies involved in congenital scoliosis consist of a jumble of vertebral defects. Progressive scoliotic curves are frequently encountered in these patients. We evaluated the results of hemi-epiphysiodesis for this patient population. A series of ten patients with unclassified scoliosis, involving multiple hemivertebrae and/or bars, was reviewed retrospectively. Hemi-epiphysiodesis was the primary treatment in all patients. Mortality, complications and wound healing problems did not occur. The average Cobb angle for all patients changed from 54 degrees (range: 40 degrees -74 degrees), preoperatively, to 58 degrees (range: 30 degrees -104 degrees), postoperatively. Applying the criterion of a minimum change of 20 degrees, to take into account measurement variability, an epiphysiodesis effect was achieved in two procedures, progression was arrested in six procedures and failure occurred in two procedures. The mean rate of Cobb angle change per annum decreased from 2.9 degrees (range: -35 degrees to 14 degrees), preoperatively, to 2.4 degrees (range: -4 degrees to 13 degrees), following surgery. Repeat surgery was necessitated by coexisting progressive kyphosis and pseudoarthrosis in one patient, and involved extension of primary epiphysiodesis in two patients. A mean intervention-free period of 58 months was established. These results suggest that hemi-epiphysiodesis stabilized the unclassified congenital scoliosis. Being under 5 years of age, having a thoracolumbar curve location, and the absence of coexisting kyphosis were found to be associated with a more favorable outcome.

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“…The placement of staples into a growing spine was later attempted, but was abandoned as the staples failed to prevent progression [14]. Recently, however, staples have regained research interest as a means to modulate spinal growth.…”

Section: Discussionmentioning

confidence: 99%

The modulation of spinal growth with nitinol intervertebral stapling in an established swine model

Carreau

Farnsworth

Glaser³

et al. 2012

Journal of Children's Orthopaedics

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Purpose Anterior spinal stapling for the treatment of adolescent idiopathic scoliosis has been shown to slow progression in small curves; however, its role in larger curves remains unclear. The purpose of this study was to evaluate the effectiveness of nitinol staples to modulate spinal growth by evaluating the two-dimensional and threedimensional morphological and histological effects of this method in a well-established porcine model. Methods Three immature Yucatan miniature pigs underwent intervertebral stapling. Two staples spanned each of three consecutive mid-thoracic discs and epiphyses. Monthly radiographs were obtained. Computed tomography (CT) was conducted at harvest after 6 months of growth. Measurements of wedging and height for each disc and vertebral body were conducted. Micro CT was used to compare physeal closure between stapled and non-stapled levels. Histology of the growth plate also compared the hypertrophic zone thickness for control and stapled vertebrae.Results After 6 months of stapled growth, the average coronal Cobb angle of the stapled segments increased by 7.7 ± 2.0°and kyphosis increased by 3.3 ± 0.6°compared to preoperative curves. Increased vertebral wedging and decreased disc height (p \ 0.001) were noted in stapled regions. Overall, 26 ± 23 % of each growth plate was closed in the stapled segments, with 6 ± 8 % closure in the unstapled levels. No difference was observed regarding the hypertrophic zone height when comparing instrumented to uninstrumented levels, nor was a difference recognized when comparing right versus left regions within stapled levels alone. Conclusions Six months of nitinol intervertebral stapling created a mild coronal and sagittal deformity associated with reduced vertebral and disc height, and increased coronal vertebral and sagittal disc wedging.

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An Operation for Stapling Vertebral Bodies in Congenital Scoliosis

Cited by 97 publications

References 0 publications

Multilevel Spinal Growth Modulation With an Anterolateral Flexible Tether in an Immature Bovine Model

Multilevel Spinal Growth Modulation With an Anterolateral Flexible Tether in an Immature Bovine Model

Hemi-epiphysiodesis for unclassified congenital scoliosis: immediate results and mid-term follow-up

The modulation of spinal growth with nitinol intervertebral stapling in an established swine model

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