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Title: Early-Onset Spinal Deformity in Skeletal Dysplasias: A Multicenter Study of Growth-Friendly Systems

Authors: White KK, Bompadre V, Shah SA, Redding GJ, Krengel WF III, Mackenzie WG, Children’s Spine Study Group, Growing Spine Study Group

Journal: Spine Deformity

Date: July 01, 2018

Excerpt: Growth-friendly techniques promote growth of the spine in patients with skeletal dysplasia. They are effective and appropriate in this patient population, and the risks are comparable to those for other patients with early-onset scoliosis.

Keywords: EOS; Skeletal Dysplasia; Pulmonary; Kyphoscoliosis

Summary:

 

What is the purpose of this study?

Skeletal dysplasia has limited growth potential in late childhood and the potential for higher complications relative to other early onset scoliosis children. This study reviewed the diverse population of skeletal dysplasia to determine the effectiveness of growth friendly surgery with respect to spine growth and elevated risks with these children.

Results

  • 23 patients with skeletal dysplasia and 23 patients without skeletal dysplasia that were treated with growth friendly surgical treatment were reviewed.
  • Percentage of spine growth at initial implant and final follow up was not statistically different between groups.
  • Complications were similar between groups. The control group had more pulmonary complications, while the skeletal dysplasia group had more neuromonitoring changes during surgery.
  • The skeletal dysplasia group had a greater complication per patient ratio (2.43/patient versus the control group 1.73/patient)

Important Discussion Points

  • Growth friendly approaches have been encouraged in the skeletal dysplasia population with increased awareness of potential pulmonary function compromise with early fusion.
  • Scoliosis in this population can be corrected and maintained, but kyphosis, which is more prevalent in this population, does not improve with treatment.
  • The efficacy of growth friendly surgery is demonstrated in this patient population.
  • Overall rate of complication in growth friendly surgical treatment is not higher in this population. Neuromonitoring changes were increased likely due to increased kyphotic deformity found in skeletal dysplasia.
  • Results are based on a very limited group of skeletal dysplasia patients, compared to an equally limited group.