Growing rods versus Shilla growth guidance: Better Cobb angle correction and t1-s1 length increase but more surgeries

被引：41
作者：
Andras L.M. [1 ]
Joiner E.R.A. [1 ]
McCarthy R.E. [2 ]
McCullough L. [2 ]
Luhmann S.J. [3 ]
Sponseller P.D. [4 ]
Emans J.B. [5 ,6 ]
Barrett K.K. [1 ]
Skaggs D.L. [1 ]
机构：
[1] Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, 90027, CA
[2] Department of Orthopaedics, Arkansas Children's Hospital, 1 Children's Way, Little Rock, 72202, AR
[3] Department of Pediatric Orthopaedics, St. Louis Children's Hospital, One Children's Place, St. Louis, 63110, MO
[4] Department of Pediatric Orthopaedics, Johns Hopkins Hospital, 1800 Orleans, St. Baltimore, 21287, MD
[5] Department of Orthopaedics, Boston Children's Hospital, 300 Longwood Avenue, Boston, 02115, MA
[6] Growing Spine Foundation, 555 East Wells St., Milwaukee, 53202, WI
来源：
Spine Deformity | 2015年 / 3卷 / 3期
关键词：
Dual growing rods; Early-onset scoliosis; Shilla;
D O I：
10.1016/j.jspd.2014.11.005
中图分类号：
学科分类号：
摘要：
Study Design Retrospective comparison. Objectives To compare treatment of early-onset scoliosis (EOS) with Shilla growth guidance versus distraction-based dual growing rods (GR). Summary of Background Data We are not aware of any prior studies comparing the Shilla procedure with other surgical procedures in the treatment of EOS. Methods The authors performed a multicenter case-matched comparison of patients with EOS treated with Shilla versus dual spine-spine GR from 1995 to 2009. A total of 36 Shilla patients from 3 centers were matched with 36 GR patients from the database by age at index surgery (±1 year), preoperative Cobb angle (±15°), and diagnosis (neuromuscular, congenital, idiopathic, or syndromic). Average follow-up was similar between groups (GR, 4.3 years; Shilla, 4.6 years; p =.353). Results Average Cobb angle improvement preoperatively to latest follow-up was 36° (range, 72° to 36°) in the GR group versus 23° (range, 69° to 45°) in the Shilla group (p =.0124). T1-S1 length increased 8.8 cm in patients treated with GR, compared with 6.4 cm in Shilla patients (p =.0170). Shilla patients had fewer surgeries (2.8) than patients in the GR group (7.4) (p <.001) but had a higher rate of unplanned surgeries for implant complications (Shilla, 1.3; GR, 0.5; p =.0151). When revisions for implant complications done at the time of scheduled lengthenings and revisions for construct maintenance were included, the groups did not differ significantly in the number of procedures for implant complications (Shilla, 1.4; GR, 1.5; p =.9451). The overall complication rate did not differ significantly between groups (Shilla, 1.9 [range, 0-7]; GR, 1.3 [range, 0-9]; p =.2085). Conclusions The GR group had a greater improvement in Cobb angle and a greater increase in T1-S1 length than Shilla. The GR patients had more surgeries but Shilla patients had more unplanned procedures. The rate of complications overall did not differ significantly between groups. © 2015 Scoliosis Research Society.
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页码：246 / 252
页数：6
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