Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Spine
Abstract number: 26647
GROWTH INSTRUMENTATION IN THE IMMATURE SCOLIOTIC SPINE
Cody BÜNGER 1 , Yu WANG 1 , Li DANG 2 , Ebbe Stender HANSEN 1 , Kirstine
HJERMITSLEV 4 , Kristian HOY 1 , Stig JESPERSEN 4 , Mahmonir EIZADPANAH 1
1 Dpt Spine Surgery, OUH and Aarhus University Hospitals, Aarhus (DENMARK),
2 Orthopaedic Research Lab, Aarhus C (DENMARK), 4 Dept Spine Surg, Odense
University Hospital, Aarhus C (DENMARK)
Preservation of growth, curve control and avoidance of complications in the patient
with major growth potential remain a major challenge in scoliosis surgery. Based on
problems with posterior tethering with Luque Trolley technique most recent technique
uses interval lengthening of the rods. Randomized studies in pigs have shown
interval locking to decrease spinal growth by 70% compared to unlocked systems.
The aim of the present study was to analyse correction of Cobb angle, growth
preservation and complications in relation to instrumentation technique. Material and
Methods: 20 patients, I median age 6 years and Cobb 78 degrees were treated from
1996 to 2009. Underlying diagnoses were SMA 7, congenital scoliosis 4, juvenile
idiopathic scoliosis 3, Recklinghausen 2, Vaters 1, Prader-Willi 1, Cruzon 1 and OI 1.
Convex epiphysiodesis and Luque Trolley technique was used in 7 Children,
whereas interval lengthening with single or double growth rods in 13 children.
Results: Postop scoliosis was reduced to median 25 degrees. In LC one early postop
death in SMA patient. Over 8 years major longitudinally spine growth of 7 cm was
observed in 5, chrankshaft in 4 and no growth in 2 pat. One reop with elongation to
sacrum. 3 conversions to growth rod.GR group lengthened every 6m showed growth
of 1,3 cm per year, rod breakage in 4, screw loosening in 2 pat. and curve
progression in all pat. Recent unlocked double rods with apical control seemed most
promising. Further developed individualized techniques are needed for this
heterogenic patient group.
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