Vertebral body stapling in children younger than 10 years with idiopathic scoliosis with curve magnitude of 30 to 39

Alexander A. Theologis, Patrick Cahill, Mike Auriemma, Randal Betz, Mohammad Diab

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

STUDY DESIGN.: Dual-center, retrospective study. OBJECTIVE.: To evaluate whether vertebral body stapling (VBS) influences curve progression between 30 and 39 in children younger than 10 years with idiopathic scoliosis. SUMMARY OF BACKGROUND DATA.: Patients younger than 10 years with idiopathic scoliosis of more than 30 have a 100% risk of progression to spine fusion regardless of nonoperative treatment. VBS may represent an alternative fusionless treatment option for this group of high-risk patients. METHODS.: Patients younger than 10 years with idiopathic thoracic or lumbar scoliosis of 30 to 39 who were treated with VBS with a minimum of 24 months of follow-up were studied. Outcome variables were curve progression and magnitude, surgical complications, and a need for reoperation. Preoperative and postoperative curve magnitudes were compared using a paired Student t test. Postoperative curve magnitudes were compared with one another using a paired Student t test. A P value of less than 0.05 was defined as statistically significant. RESULTS.: Twelve patients were studied (female: n = 12; average age: 7.8 yr [range: 6.3-9.7 yr]). Thirteen curves were treated with VBS (thoracic: n = 9; lumbar: n = 4). The average follow-up was 3.4 years (range: 2.2-5.4 yr). The average preoperative curve magnitude was 33.4 (range: 30 -39 ). The immediate postoperative curve magnitude (19.0 ; range: 0 -29 ) and curve magnitude at the most recent follow-up (23.0 ; range: 10 -34 ) were significantly less than the preoperative magnitude of 33.4 . Both thoracic curves (100%) and lumbar curves (100%) were treated successfully. Curve magnitudes did not change significantly postoperatively between the first erect radiographs and the most recent follow-up. Two patients had pneumothorax, and 1 patient had symptomatic pleural effusion. No patient required definitive fusion for curve progression. CONCLUSION.: VBS is effective in controlling curve progression in the high-risk group of children younger than 10 years with idiopathic scoliosis between 30 and 39 in whom bracing may be ineffective.

Original languageEnglish
Pages (from-to)E1583-E1588
JournalSpine
Volume38
Issue number25
DOIs
StatePublished - 1 Dec 2013
Externally publishedYes

Keywords

  • 30°-39°
  • bracing
  • clinical outcomes
  • fusionless surgery
  • juvenile idiopathic scoliosis
  • lumbar scoliosis
  • prepubescent
  • thoracic scoliosis
  • thoracoscopic
  • vertebral body staples

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