Spring distraction system for dynamic growth guidance of early onset scoliosis: two-year prospective follow-up of 24 patients

Abstract

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Identifying complications and failure modes of innovative growing rod configurations using the (hybrid) magnetically controlled growing rod (MCGR) and the spring distraction system (SDS)

“…This implant has important advantages, such as the potential to further reduce the curve after insertion and the fact that it does not have to be periodically lengthened. The design of the SDS and its preliminary and 2-year follow-up clinical performance have recently been reported [15,16]. However, its provisional design is not yet fully optimised, as the connectors are used off-label and do not prevent the release of metal debris.…”

Surgical management of early-onset scoliosis: indications and currently available techniques

“…A recent report on 24 patients with EOS (5 idiopathic, 7 congenital, 3 syndromic, 9 neuromuscular) and 2-year postoperative follow-up indicated that the concept of spring distraction can be feasible as an alternative to present growing spine solutions without the need for repeat lengthening. 25,26 Scoliosis correction and growth was maintained at follow-up; however, the rate of reoperations was high (17 of 24 patients) which indicates that this technique requires further improvement. Further longer-term investigations into the effectiveness, risk of revision surgery and complications are expected.…”

“…In this way, the technique aims to control the apical segments by local derotation and fusion, while allowing for proximal and distal spinal growth. In 2013, McCarthy et al 25 showed that the Shilla technique required fewer reoperations (3 versus 7) but resulted in reduced spinal growth (0.7 cm/year) and lesser scoliosis correction with higher complication rates compared to growing rods. Therefore, its use has become limited to selective cases which need apical control.…”

“…Recently, the spring-distraction aided growth guidance concept (Spring Distraction System) has been introduced as a promising growth-friendly technique; this works with integration of a continuous distraction force exerted by a spring with a sliding technique, without the need for repetitive surgeries. 25,26 In more detail, the implant is similar to dual traditional growing rods, except for that it includes compressed helical springs positioned around the rods and that the parallel rod connector is left dynamic to allow for longitudinal spinal growth. Lengthening is achieved by active continuous distraction through the compressed springs using the inherent spinal growth, while the rods can slide through the parallel connectors.…”

Vital Role of In-House 3D Lab to Create Unprecedented Solutions for Challenges in Spinal Surgery, Practical Guidelines and Clinical Case Series

“…The cervical guide has been applied in two cases of spinal distraction and one case of emergency treatment. In our center, we use spring distraction as a growth guidance technique for severe deformities that cannot be controlled with less invasive techniques such as braces or halo vests [ 27 ]. For cervicothoracic congenital deformities especially, the technique has shown the potential to not only control but even to reduce the deformity [ 28 ].…”