World Neurosurg. 2021 Aug 28:S1878-8750(21)01273-0. doi: 10.1016/j.wneu.2021.08.096. Online ahead of print.
ABSTRACT
BACKGROUND CONTEXT: The term early onset scoliosis (EOS) refers to spinal deformities that develop before the age of 10. The aim of surgical treatment for EOS is stopping the progression of the curvature, maintaining the correction, ensuring the maximum growth of the vertebrae and ensuring that the vertebrae remain mobile. Using MCGR in the treatment of EOS is intended to protect the patient from negative effects of repetitive surgeries, increase the patient’s compliance and satisfaction, and increase the speed of return to normal social life.
PURPOSE: Our aim is to report early radiological evaluation and detect changes in the quality of life of patients and their parents after diagnosis of early onset scoliosis (EOS) and treatment with magnetically controlled growing rods (MCGR).
STUDY DESIGN/SETTING: Retrospective clinical study (Level 4 case series) OUTCOME MEASURES: Cobb angle, thoracic kyphosis, spinal height, thoracic height, sagittal balance, coronal balance, shoulder balance and pelvic balance were measured. All patients received preoperative and final follow-up respiratory function tests, and the parents of every patient completed the Turkish version of the EOSQ-24 questionnaire PATIENT SAMPLE: Twenty patients with surgical indication for treatment of EOS METHODS: A total of 20 patients who were treated with MCGR and had lengthening procedures at 3-month intervals between August 2014 and August 2016 were included in the study. The mean age at the time of surgery was 7.9 years (4-10) and the mean length of follow-up was 14.9 months (6-30). Preoperative, early postoperative and final follow-up x-rays of all patients were obtained. From the x-rays, Cobb angle, thoracic kyphosis, spinal height, thoracic height, sagittal balance, coronal balance, shoulder balance, and pelvic balance were measured. All patients received preoperative and final follow-up respiratory function tests, and all patients completed the Early Onset Scoliosis Questionnaire (EOSQ-24) RESULTS: Preoperative, early postoperative and final follow-up mean Cobb angles were 56.6 degrees (38-93), 30.5 degrees (13-80) and 33.5 degrees (14-86), respectively. These findings showed statistically significant improvement in Cobb angle (p<0.05). Thoracic height was also significantly increased; the preoperative mean was 181 mm (123-224), the early postoperative mean was 200 mm (164-245) and the final follow-up mean was 212 mm (167-248; p<0.05). Measurements for spinal height also increased significantly with preoperative, early postoperative, and final follow-up values of 219 mm (213-366), 315 mm (260-402), and 338 mm (261-406), respectively (p<0.05). Thoracic kyphosis measurements was 41 degrees (5-65) preoperatively, and this value decreased significantly to 32.5 degrees (0-53) in the final follow-up (p<0.05). Our measurements showed no statistically significant differences in coronal and sagittal balance, pelvic balance, or shoulder balance. There were no significant differences between preoperative and postoperative respiratory function tests. Assessment using the EOSQ-24 questionnaire demonstrated significant improvements in mean scores at final follow-up (p<0.05). When different categories in the questionnaire were evaluated separately, there were no statistically significant differences between preoperative and final follow-up scores of general health, pain/discomfort, respiratory function, movement capability, physical function or effects on daily life (p>0.05). However, exhaustion and energy levels, emotional state, effect of the disease on parents and the patient, and parent satisfaction scores increased significantly from preoperative assessment to final follow-up (p<0.05). Financial effect decreased significantly in final follow-up compared to preoperative values (p<0.05). Four patients developed complications requiring further treatment, and none of the patients developed infection that required surgical intervention.
CONCLUSIONS: Our study showed that insertion of a MCGR is a safe procedure for treatment of EOS to correct deformity and improve function in daily life. This method reduces the need for repetitive surgery and the likelihood of complications associated with other treatments. As a result, treatment with MCGR increases patient satisfaction and facilitates patient compliance.
PMID:34464772 | DOI:10.1016/j.wneu.2021.08.096
