Skip Navigation LinksHome > December 01, 2013 - Volume 38 - Issue 25 > Vertebral Body Stapling in Children Younger Than 10 Years Wi...
Spine:
doi: 10.1097/BRS.0b013e3182a8280d
Deformity

Vertebral Body Stapling in Children Younger Than 10 Years With Idiopathic Scoliosis With Curve Magnitude of 30° to 39°

Theologis, Alexander A. MD*; Cahill, Patrick MD; Auriemma, Mike BS; Betz, Randal MD; Diab, Mohammad MD*

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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.

Level of Evidence: 4

© 2013 by Lippincott Williams & Wilkins

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