Risk Factors for Complications Associated With Growing-Rod Surgery for Early-Onset Scoliosis

Abstract

Increases in the upper thoracic scoliotic curve, thoracic kyphosis, and number of rod-lengthening procedures are positively associated with an increased risk of complications after GR surgery for EOS.

Risk factors for predicting complications associated with growing rod surgery for early-onset scoliosis

“…In line with the study of Watanabe et al [20], our study demonstrated that of the implant-related failures, the majority of the implant dislodgements occurred at the proximal foundation (92%). A possible explanation may be that the higher risk of complications might result from a continuous asymmetrical force load at the proximal foundation postoperatively.…”

“…Watanabe et al [20], found that an increase of every 20 • in the proximal thoracic cobb angle as one of the independent risk factors for postoperative complications and the reduced stability of the proximal foundation resulted from the difficulty of placing pedicle screws and hooks in a proximal severe thoracic spine accounted for the implant dislodgements. In line with the study of Watanabe et al [20], our study demonstrated that of the implant-related failures, the majority of the implant dislodgements occurred at the proximal foundation (92%).…”

Traditional Growing Rods Versus Magnetically Controlled Growing Rods for the Surgical Treatment of Early-Onset Scoliosis: A Case-Matched 2-Year Study

“…Traditional growing rod surgery requires periodic surgical lengthenings of the constructdtypically every 6 monthsdto maintain curve correction and allow continued spinal growth [6]. Recent studies on TGR surgery have shown that repeated surgical lengthenings significantly increase the risk of complications [7,8].…”

Early-Onset Scoliosis: A Review of History, Current Treatment, and Future Directions

“…Risk factors for implant failures include severe thoracic kyphosis that produces proximal anchor pullout and increased number of lengthening procedures. 40 Implantation strategies are being critically evaluated to decrease the incidence of implant-related complications. A comparison study of complications in TGRs, hybrid proximal rib anchor systems, and VEPTR treatments in EOS demonstrated a trend toward decreased implant-related complications in the hybrid system.…”

“…29,30,[38][39][40][41][42][43] Implant complications such as anchor malfunction (pullout from the spine, erosion through the rib) and rod breakage are common (Fig 9). Distraction-based posterior implants often produce kyphosis, which may result in an unfavorable overall sagittal plane balance.…”