The titanium-made growth-guidance technique for early-onset scoliosis
at minimum 2-year follow-up: A prospective multicenter study

Miękisiak, Grzegorz; Kołtowski, Krzysztof; Menartowicz, Piotr; Oleksik, Zygmunt; Kotulski, Dariusz; Repko, Martin; Filipovič, Milan; Danielewicz, Anna; Fatyga, Marek; Latalski, M

doi:10.17219/acem/102269

Cited by 3 publications

(1 citation statement)

References 21 publications

(27 reference statements)

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“…In moderate cases, spinal bracing is the standard method and the most widely used approach to correct spinal deformity and prevent the progression of the scoliosis [2][3][4]. Patients with a Cobb angle greater than 40 degrees often require surgical treatment, and various surgical systems may be applied to correct the spinal deformity [5][6][7][8]. The aim of surgery in the treatment of AIS is to improve cosmesis and function with low complication rates and minimal long-term implications.…”

Section: Introductionmentioning

confidence: 99%

Metabolic Imbalances and Bone Remodeling Agents in Adolescent Idiopathic Scoliosis: A Study in Postmenarcheal Girls

Danielewicz,

Wójciak,

Sowa

et al. 2023

IJMS

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The causes and mechanisms underlying adolescent idiopathic scoliosis (AIS) remain unclear, and the available information regarding metabolic imbalances in AIS is still insufficient. This investigation aimed to evaluate the concentrations of specific bone remodeling-related agents in postmenarcheal girls diagnosed with AIS. The study encompassed thirty-six scoliosis patients and eighteen age-matched healthy individuals assigned to the control group. The patients underwent clinical and radiological examinations to assess the degree of the spinal deformity, type of curvature, and skeletal maturity. Blood and urine samples were collected from all participants and serological markers were measured using an enzyme-linked immunosorbent assay. Our study results demonstrated that the balance of phosphate–calcium and parathormone levels seems normal in individuals with AIS. Furthermore, no statistically significant differences were observed in the content of Klotho protein, osteocalcin, osteoprotegerin, C-terminal telopeptide of type I collagen (CTX), sclerostin, and alkaline phosphatase. Nevertheless, the serum levels of vitamin D (25-OH-D) were lowered, while N-terminal propeptide of type I procollagen (PINP), and fibroblast growth factor-23 (FGF23) were increased in the AIS group, with p-values of 0.044, 0.001, and 0.022, respectively. This finding indicates the potential involvement of these factors in the progression of AIS, which necessitates further studies to uncover the fundamental mechanisms underlying idiopathic scoliosis.

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Section: Introductionmentioning

confidence: 99%

Metabolic Imbalances and Bone Remodeling Agents in Adolescent Idiopathic Scoliosis: A Study in Postmenarcheal Girls

Danielewicz,

Wójciak,

Sowa

et al. 2023

IJMS

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Comparison of surgical interventions for the treatment of early-onset scoliosis: a systematic review and meta-analysis

Kim

Sammak

Michalopoulos

et al. 2022

Journal of Neurosurgery: Pediatrics

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OBJECTIVE Several growth-preserving surgical techniques are employed in the management of early-onset scoliosis (EOS). The authors’ objective was to compare the use of traditional growing rods (TGRs), magnetically controlled growing rods (MCGRs), Shilla growth guidance techniques, and vertically expanding prosthetic titanium ribs (VEPTRs) for the management of EOS. METHODS A systematic review of electronic databases, including Ovid MEDLINE and Cochrane, was performed. Outcomes of interest included correction of Cobb angle, T1–S1 distance, and complication rate, including alignment, hardware failure and infection, and planned and unplanned reoperation rates. The percent changes and 95% CIs were pooled across studies using random-effects meta-analysis. RESULTS A total of 67 studies were identified, which included 2021 patients. Of these, 1169 (57.8%) patients underwent operations with TGR, 178 (8.8%) Shilla growth guidance system, 448 (22.2%) MCGR, and 226 (11.1%) VEPTR system. The mean ± SD age of the cohort was 6.9 ± 1.2 years. The authors found that the Shilla technique provided the most significant improvement in coronal Cobb angle immediately after surgery (mean [95% CI] 64.2° [61.4°–67.2°]), whereas VEPTR (27.6% [22.7%–33.6%]) and TGR (45% [42.5%–48.5%]) performed significantly worse. VEPTR also performed significantly worse than the other techniques at final follow-up. The techniques also provided comparable gains in T1–S1 height immediately postoperatively (mean [95% CI] 10.5% [9.0%–12.0%]); however, TGR performed better at final follow-up (21.3% [18.6%–24.1%]). Complications were not significantly different among the patients who underwent the Shilla, TGR, MCGR, and VEPTR techniques, except for the rate of infections. The TGR technique had the lowest rate of unplanned reoperations (mean [95% CI] 15% [10%–23%] vs 24% [19%–29%]) but the highest number of planned reoperations per patient (5.31 [4.83–5.82]). The overall certainty was also low, with a high risk of bias across studies. CONCLUSIONS This analysis suggested that the Shilla technique was associated with a greater early coronal Cobb angle correction, whereas use of VEPTR was associated with a lower correction rate at any time point. TGR offered the most significant height gain at final follow-up. The complication rates were comparable across all surgical techniques. The optimal surgical approach should be tailored to individual patients, taking into consideration the strengths and limitations of each option.

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Complications in growth-friendly spinal surgeries for early-onset scoliosis: Literature review

Latalski¹,

Fatyga²,

Sowa³

et al. 2021

WJO

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BACKGROUND The treatments for early-onset scoliosis (EOS), defined as curvature of the spine with onset before 10 years of age, continue to pose a great challenge for pediatric orthopedics. The treatment goals for EOS include minimizing spinal deformity while maximizing thoracic volume and pulmonary function. Different surgical techniques have different advantages and drawbacks; however, the two major concerns in the management of EOS are repeated surgeries and complications. AIM To review the current literature to assess the safety of EOS surgical treatment in terms of the rate of complications and unplanned surgeries. METHODS In January 2021 two independent reviewers systematically searched three electronic medical databases (PubMed, the Cochrane Library, and Embase) for relevant articles. Every step of the review was done according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Due to the heterogeneity of articles and topics after data analysis, a descriptive (synthetic) analysis was performed. RESULTS A total of 2136 articles were found. Forty articles were included in this systematic review, after applying our inclusion and exclusion criteria. EOS surgery has a varying but high rate of complications. The most frequent complications were categorized as implant (54%), general (17%), wound (15%) and alignment (12%). The rate of complications might have been even higher than reported, as some authors do not report all types of complications. About 54% of patients required unplanned surgeries due to complications, which comprised 15% of all surgeries. CONCLUSION The literature concerning the definitions, collection, and interpretation of data regarding EOS surgery complications is often difficult to interpret. This creates problems in the comparison, analysis, and improvement of spine surgery practice. Additionally, this observation indicates that data on the incidence of complications can be underestimated, and should be interpreted with caution. Awareness of the high rate of complications of EOS surgery is crucial, and an optimal strategy for prevention should become a priority.

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The titanium-made growth-guidance technique for early-onset scoliosis at minimum 2-year follow-up: A prospective multicenter study

Cited by 3 publications

References 21 publications

Metabolic Imbalances and Bone Remodeling Agents in Adolescent Idiopathic Scoliosis: A Study in Postmenarcheal Girls

Metabolic Imbalances and Bone Remodeling Agents in Adolescent Idiopathic Scoliosis: A Study in Postmenarcheal Girls

Comparison of surgical interventions for the treatment of early-onset scoliosis: a systematic review and meta-analysis

Complications in growth-friendly spinal surgeries for early-onset scoliosis: Literature review

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