Dual Growing-Rods effective in treating Severe Early-Onset Scoliosis in the long term

Yunsheng Wang et al evaluated long-term outcomes (radiographic parameters and pulmonary function) at a minimum follow up of 5 years after use of dual growing rods (DGRs) to treat severe early-onset scoliosis (sEOS). The study was performed at Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China. It has been published in ‘THE JOURNAL OF BONE AND JOINT SURGERY.’

Among a total of 112 patients who were diagnosed with early-onset scoliosis (EOS) and were treated with DGRs, 52 patients had sEOS, with a major Cobb angle of >800. Of these patients, 39 with a minimum follow-up of 5 years had complete radiographic and pulmonary function test results and were included. The Cobb angle of the major curve, T1-S1 height, T1-T12 height, and maximum kyphosis angle in the sagittal plane were measured on radiographs. Pulmonary function test results were collected in all patients before the initial operation (preoperatively), 12 months after the initial operation (postoperatively), and at the last follow-up. The changes in pulmonary function and complications during treatment were analyzed.

Key findings of the study were:

• The mean age of patients before the initial operation was 7.7 ± 1.2 years, and the mean follow-up period was 75.0 ± 14.1 months.

• The mean number of lengthenings was 4.5 ± 1.3, and the mean interval between lengthenings was 11.2 ± 2.1 months.

• The Cobb angle improved from 104.50 ± 18.20 preoperatively to 38.10 ± 10.10 after the initial surgical procedure (postoperatively) and 21.90 ± 8.60 at the final follow-up.

• The T1-S1 height increased from 25.1 ± 4.0 cm preoperatively to 32.4 ± 3.5 cm postoperatively and to 39.5 ± 4.0 cm at the final follow-up.

• No significant difference was detected between the increased pulmonary function parameters at 1 year and those before the operation (p > 0.05), except for residual volume, whereas pulmonary function parameters had significantly increased at the final follow-up (p < 0.05).

• During the treatment period, 17 complications occurred in 12 patients.

The authors concluded that- “DGRs are effective in treating sEOS in the long term. They allow longitudinal growth of the spine, and the correction of the spinal deformity can provide conditions that make improving pulmonary function possible in patients with sEOS.”

Level of Evidence: Therapeutic Level IV.

Further reading:

Long-Term Radiographic and Pulmonary Function Outcomes After Dual Growing-Rod Treatment for Severe Early-Onset Scoliosis

Yunsheng Wang, Yong Hai et al

J Bone Joint Surg Am. 2023;105:915-23

http://dx.doi.org/10.2106/JBJS.22.01088