A1 Refereed original research article in a scientific journal
Results of growth-friendly management of early-onset scoliosis in children with and without skeletal dysplasias A MATCHED COMPARISON
Authors: I. J. Helenius, A. J. Saarinen, K. K. White, A. McClung, M. Yazici, S. Garg, G. H. Thompson, C. E. Johnston, J. M. Pahys, M. G. Vitale, B. A. Akbarnia, P. D. Sponseller
Publisher: BRITISH EDITORIAL SOC BONE JOINT SURGERY
Publication year: 2019
Journal: Bone and Joint Journal
Journal name in source: BONE & JOINT JOURNAL
Journal acronym: BONE JOINT J
Volume: 101B
Issue: 12
First page : 1563
Last page: 1569
Number of pages: 7
ISSN: 2049-4394
DOI: https://doi.org/10.1302/0301-620X.101B12.BJJ-2019-0735.R1
Abstract
Aims
The aim of this study was to compare the surgical and quality-of-life outcomes of children with skeletal dysplasia to those in children with idiopathic early-onset scoliosis (EOS) undergoing growth-friendly management.
Patients and Methods
A retrospective review of two prospective multicentre EOS databases identified 33 children with skeletal dysplasia and EOS (major curve >= 30 degrees) who were treated with growth-friendly instrumentation at younger than ten years of age, had a minimum two years of postoperative follow-up, and had undergone three or more lengthening procedures. From the same registries, 33 matched controls with idiopathic EOS were identified. A total of 20 children in both groups were treated with growing rods and 13 children were treated with vertical expandable prosthetic titanium rib (VEPTR) instrumentation.
Results
Mean preoperative major curves were 76 degrees (34 degrees to 115 degrees) in the skeletal dysplasia group and 75 degrees (51 degrees to 113 degrees) in the idiopathic group (p = 0.55), which were corrected at final follow-up to 49 degrees (13 degrees to 113 degrees) and 46 degrees (12 degrees to 112 degrees; p = 0.68), respectively. T1-S1 height increased by a mean of 36 mm (0 to 105) in the skeletal dysplasia group and 38 mm (7 to 104) in the idiopathic group at the index surgery (p = 0.40), and by 21 mm (1 to 68) and 46 mm (7 to 157), respectively, during the distraction period (p = 0.0085). The skeletal dysplasia group had significantly worse scores in the physical function, daily living, financial impact, and parent satisfaction preoperatively, as well as on financial impact and child satisfaction at final follow-up, than the idiopathic group (all p < 0.05). The domains of the 24-Item Early-Onset Scoliosis Questionnaire (E0SQ24) remained at the same level from preoperative to final follow-up in the skeletal dysplasia group (all p > 0.10).
ConclusionChildren with skeletal dysplasia gained significantly less spinal growth during growth-friendly management of their EOS and their health-related quality of life was significantly lower both preoperatively and at final follow-up than in children with idiopathic EOS.
Aims
The aim of this study was to compare the surgical and quality-of-life outcomes of children with skeletal dysplasia to those in children with idiopathic early-onset scoliosis (EOS) undergoing growth-friendly management.
Patients and Methods
A retrospective review of two prospective multicentre EOS databases identified 33 children with skeletal dysplasia and EOS (major curve >= 30 degrees) who were treated with growth-friendly instrumentation at younger than ten years of age, had a minimum two years of postoperative follow-up, and had undergone three or more lengthening procedures. From the same registries, 33 matched controls with idiopathic EOS were identified. A total of 20 children in both groups were treated with growing rods and 13 children were treated with vertical expandable prosthetic titanium rib (VEPTR) instrumentation.
Results
Mean preoperative major curves were 76 degrees (34 degrees to 115 degrees) in the skeletal dysplasia group and 75 degrees (51 degrees to 113 degrees) in the idiopathic group (p = 0.55), which were corrected at final follow-up to 49 degrees (13 degrees to 113 degrees) and 46 degrees (12 degrees to 112 degrees; p = 0.68), respectively. T1-S1 height increased by a mean of 36 mm (0 to 105) in the skeletal dysplasia group and 38 mm (7 to 104) in the idiopathic group at the index surgery (p = 0.40), and by 21 mm (1 to 68) and 46 mm (7 to 157), respectively, during the distraction period (p = 0.0085). The skeletal dysplasia group had significantly worse scores in the physical function, daily living, financial impact, and parent satisfaction preoperatively, as well as on financial impact and child satisfaction at final follow-up, than the idiopathic group (all p < 0.05). The domains of the 24-Item Early-Onset Scoliosis Questionnaire (E0SQ24) remained at the same level from preoperative to final follow-up in the skeletal dysplasia group (all p > 0.10).
ConclusionChildren with skeletal dysplasia gained significantly less spinal growth during growth-friendly management of their EOS and their health-related quality of life was significantly lower both preoperatively and at final follow-up than in children with idiopathic EOS.
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