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*Do Growth Guidance Rods Have Acceptable Complications and Fewer Surgeries?: Paper #38

McCarthy, Richard E. MD (Arkansas Childrens Hospital); Luhmann, Scott J. MD; Lenke, Lawrence G. MD; McCullough, Frances MNSc

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Spine Journal Meeting Abstracts: September 2009 - Volume 10 - Issue - p 81
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Introduction: Twenty‐two pts with the growth guidance system for correction of spinal deformities in early onset scoliosis (EOS) were evaluated at 2 yr follow‐up at 2 centers. We wanted to determine if the number of returns to surgery and complications were comparable to traditional distraction based growing rods.

Methods: The favorable results of treatment of > than 50 degree EOS with the growth guidance procedure have been previously reported. We are critically analyzing the complications of 22 pts. with > than 2 yr (2–3.6) follow‐up at 2 centers with 3 surgeons. The diagnoses were Idiopathic (9), Neuromuscular (10), Congenital (2), and Intrathecal tumor (1).

Results: The complications were divided into groups: Implant related‐11pts (7 with prominent implants, 4 with broken rods) Wound related‐ 4 pts. (3 washouts or plastic proc., 1 implant removal) Alignment ‐3 pts. (All corrected at final fusion) General‐1 pt. Pleural effusion (CT). Total number of complications was 30 with 26 unplanned operative procedures. Three pts completed sufficient growth for final fusion. There were no neurologic changes in any pts.

Conclusion: Thirty complications in this complex group of EOS patients is comparable to Akbarnia's reports with distraction growing rods, however, their patients underwent planned operative lengthenings. If our group of patients had lengthenings every six months they would have had an additional 115 procedures from which they were spared due to the growth guidance without operative lengthening of the Shilla. Eight of our patients had more than one complication implying they were predisposed to problems due to underlying illness, i.e. Spina Bifida or level of activity. Rod breakage occurred more frequently in active, ambulatory children with smaller rods (3.5mm).

Significance: The growth guidance patients had complications at a level comparable to what has been reported in the literature for growing rods while being spared an additional 115 procedures for spinal lengthening.

© 2009 Lippincott Williams & Wilkins, Inc.