Continuous lengthening potential after four years of magnetically controlled spinal deformity correction in children with spinal muscular atrophy

Abstract Magnetically controlled growing rods (MCGR) are commonly implanted for the treatment of early-onset scoliosis. While most authors report favorable short-term results, little is known about long-term deformity correction. This prospective cohort study assesses spinal deformity control in a h...

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Autores principales:	Heiko M. Lorenz, Marina M. Hecker, Lena Braunschweig, Batoul Badwan, Konstantinos Tsaknakis, Anna K. Hell
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0b8d6f8d77154b2bad1da7de6bde1558
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spelling	oai:doaj.org-article:0b8d6f8d77154b2bad1da7de6bde15582021-12-02T15:12:41ZContinuous lengthening potential after four years of magnetically controlled spinal deformity correction in children with spinal muscular atrophy10.1038/s41598-020-79821-x2045-2322https://doaj.org/article/0b8d6f8d77154b2bad1da7de6bde15582020-12-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-79821-xhttps://doaj.org/toc/2045-2322Abstract Magnetically controlled growing rods (MCGR) are commonly implanted for the treatment of early-onset scoliosis. While most authors report favorable short-term results, little is known about long-term deformity correction. This prospective cohort study assesses spinal deformity control in a homogeneous spinal muscular atrophy (SMA) patient group treated with MCGR implants, a standardized lengthening protocol and a minimum follow-up of four years. 17 SMA patients with progressive scoliosis were treated with MCGR implanted parallel to the spine with rib-to-pelvis fixation. Radiologic measurements were performed before and after MCGR implantation and during external lengthening procedures. These included measurements of the scoliotic curve, kyphosis, lordosis, pelvic obliquity and the spinal length. Additional clinical data of the complications were also analyzed. 17 children (mean age 7.4 years) were surgically treated and underwent a total of 376 lengthenings. Complication rates were 3.5% in respect to all interventions or 41% of the patients had complications during 3.5% of the lengthening sessions. The initial implantation significantly reduced the main scoliotic curve by 59%, with the correction remaining constant throughout the follow-up. Pelvic obliquity was also significantly and permanently corrected by 72%, whereas kyphosis and lordosis were not influenced. The spinal length could be significantly increased mostly during the first year of treatment. Bilateral implantation of MCGRs for correction of spinal deformity in children with SMA showed no decrease of the lengthening potential during a four-year follow-up. Therefore, the previously described ‘law of diminishing returns’ could not be applied to this patient population. Level of Evidence/Clinical relevance: Therapeutic Level IV.Heiko M. LorenzMarina M. HeckerLena BraunschweigBatoul BadwanKonstantinos TsaknakisAnna K. HellNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-8 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Heiko M. Lorenz Marina M. Hecker Lena Braunschweig Batoul Badwan Konstantinos Tsaknakis Anna K. Hell Continuous lengthening potential after four years of magnetically controlled spinal deformity correction in children with spinal muscular atrophy
description	Abstract Magnetically controlled growing rods (MCGR) are commonly implanted for the treatment of early-onset scoliosis. While most authors report favorable short-term results, little is known about long-term deformity correction. This prospective cohort study assesses spinal deformity control in a homogeneous spinal muscular atrophy (SMA) patient group treated with MCGR implants, a standardized lengthening protocol and a minimum follow-up of four years. 17 SMA patients with progressive scoliosis were treated with MCGR implanted parallel to the spine with rib-to-pelvis fixation. Radiologic measurements were performed before and after MCGR implantation and during external lengthening procedures. These included measurements of the scoliotic curve, kyphosis, lordosis, pelvic obliquity and the spinal length. Additional clinical data of the complications were also analyzed. 17 children (mean age 7.4 years) were surgically treated and underwent a total of 376 lengthenings. Complication rates were 3.5% in respect to all interventions or 41% of the patients had complications during 3.5% of the lengthening sessions. The initial implantation significantly reduced the main scoliotic curve by 59%, with the correction remaining constant throughout the follow-up. Pelvic obliquity was also significantly and permanently corrected by 72%, whereas kyphosis and lordosis were not influenced. The spinal length could be significantly increased mostly during the first year of treatment. Bilateral implantation of MCGRs for correction of spinal deformity in children with SMA showed no decrease of the lengthening potential during a four-year follow-up. Therefore, the previously described ‘law of diminishing returns’ could not be applied to this patient population. Level of Evidence/Clinical relevance: Therapeutic Level IV.
format	article
author	Heiko M. Lorenz Marina M. Hecker Lena Braunschweig Batoul Badwan Konstantinos Tsaknakis Anna K. Hell
author_facet	Heiko M. Lorenz Marina M. Hecker Lena Braunschweig Batoul Badwan Konstantinos Tsaknakis Anna K. Hell
author_sort	Heiko M. Lorenz
title	Continuous lengthening potential after four years of magnetically controlled spinal deformity correction in children with spinal muscular atrophy
title_short	Continuous lengthening potential after four years of magnetically controlled spinal deformity correction in children with spinal muscular atrophy
title_full	Continuous lengthening potential after four years of magnetically controlled spinal deformity correction in children with spinal muscular atrophy
title_fullStr	Continuous lengthening potential after four years of magnetically controlled spinal deformity correction in children with spinal muscular atrophy
title_full_unstemmed	Continuous lengthening potential after four years of magnetically controlled spinal deformity correction in children with spinal muscular atrophy
title_sort	continuous lengthening potential after four years of magnetically controlled spinal deformity correction in children with spinal muscular atrophy
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/0b8d6f8d77154b2bad1da7de6bde1558
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Continuous lengthening potential after four years of magnetically controlled spinal deformity correction in children with spinal muscular atrophy

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