Clinical and radiological results of final fusion in patients who underwent lengthening with magnetically controlled growing rods. About 66 patients with a mean follow-up of 5 years

Purpose The aim of this study was to evaluate the effects of definitive arthrodesis on frontal and sagittal spine balance in EOS patients treated with MCGR, as well as the complications associated with this procedure and the outcome at last follow-up. Methods This was a multicentre study in 10 Frenc...

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Vydáno v:	European spine journal Ročník 32; číslo 9; s. 3118 - 3132
Hlavní autoři:	Mainard, Nicolas, Saghbini, Elie, Langlais, Tristan, Vialle, Raphael, Nectoux, Eric, Sales de Gauzy, Jerome, Fron, Damien, Canavese, Federico
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2023 Springer Nature B.V Springer Verlag
Edice:	European Spine Journal
Témata:	Arthrodesis Back surgery Complications Etiology Hospitals Life Sciences Medicine Medicine & Public Health Neurosurgery Original Article Orthopedics Patients Pediatrics Postoperative Scoliosis Surgical Orthopedics Early onset scoliosis Spinal growth Magnetically controlled growing rod Graduate Posterior spinal fusion
ISSN:	0940-6719, 1432-0932, 1432-0932
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Abstract	Purpose The aim of this study was to evaluate the effects of definitive arthrodesis on frontal and sagittal spine balance in EOS patients treated with MCGR, as well as the complications associated with this procedure and the outcome at last follow-up. Methods This was a multicentre study in 10 French centres. All patients who underwent posterior spinal arthrodesis after completion of MCGR treatment, regardless of age, etiology of scoliosis between 2011 and 2022, were included. Results A total of 66 patients who had a final fusion after the lengthening programme were included in the study. The mean follow-up time was 5.5 ± 1.7 years (range: 2.1–9). The mean follow-up time after arthrodesis was 24 ± 18 months (range: 3–68) and the mean age at arthrodesis was 13.5 ± 1.5 years (range: 9.5–17). The main and secondary curves were significantly ( p < 0.005 and p = 0.03) improved by arthrodesis (16.4° and 9° respectively) and stabilised at the last follow-up. The T1-T12 and T1-S1 distances increased by 8.4 mm and 14 mm with spinal fusion, with no significant difference ( p = 0.096 and p = 0.068). There was no significant improvement in the rest of the parameters with arthrodesis, nor was there any significant deterioration at last follow-up. After final fusion, there were a total of 24 complications in 18 patients (27.3%) that routinely led to repeat surgery. Conclusion Final fusion after MCGR provides satisfactory additional correction of the main and secondary curves and a moderate increase in the T1-T12 distance but has no impact on sagittal balance and other radiological parameters. The post-operative complication rate is particularly high in patients at risk of complications. Level of evidence Level 4.
AbstractList	The aim of this study was to evaluate the effects of definitive arthrodesis on frontal and sagittal spine balance in EOS patients treated with MCGR, as well as the complications associated with this procedure and the outcome at last follow-up.PURPOSEThe aim of this study was to evaluate the effects of definitive arthrodesis on frontal and sagittal spine balance in EOS patients treated with MCGR, as well as the complications associated with this procedure and the outcome at last follow-up.This was a multicentre study in 10 French centres. All patients who underwent posterior spinal arthrodesis after completion of MCGR treatment, regardless of age, etiology of scoliosis between 2011 and 2022, were included.METHODSThis was a multicentre study in 10 French centres. All patients who underwent posterior spinal arthrodesis after completion of MCGR treatment, regardless of age, etiology of scoliosis between 2011 and 2022, were included.A total of 66 patients who had a final fusion after the lengthening programme were included in the study. The mean follow-up time was 5.5 ± 1.7 years (range: 2.1-9). The mean follow-up time after arthrodesis was 24 ± 18 months (range: 3-68) and the mean age at arthrodesis was 13.5 ± 1.5 years (range: 9.5-17). The main and secondary curves were significantly (p < 0.005 and p = 0.03) improved by arthrodesis (16.4° and 9° respectively) and stabilised at the last follow-up. The T1-T12 and T1-S1 distances increased by 8.4 mm and 14 mm with spinal fusion, with no significant difference (p = 0.096 and p = 0.068). There was no significant improvement in the rest of the parameters with arthrodesis, nor was there any significant deterioration at last follow-up. After final fusion, there were a total of 24 complications in 18 patients (27.3%) that routinely led to repeat surgery.RESULTSA total of 66 patients who had a final fusion after the lengthening programme were included in the study. The mean follow-up time was 5.5 ± 1.7 years (range: 2.1-9). The mean follow-up time after arthrodesis was 24 ± 18 months (range: 3-68) and the mean age at arthrodesis was 13.5 ± 1.5 years (range: 9.5-17). The main and secondary curves were significantly (p < 0.005 and p = 0.03) improved by arthrodesis (16.4° and 9° respectively) and stabilised at the last follow-up. The T1-T12 and T1-S1 distances increased by 8.4 mm and 14 mm with spinal fusion, with no significant difference (p = 0.096 and p = 0.068). There was no significant improvement in the rest of the parameters with arthrodesis, nor was there any significant deterioration at last follow-up. After final fusion, there were a total of 24 complications in 18 patients (27.3%) that routinely led to repeat surgery.Final fusion after MCGR provides satisfactory additional correction of the main and secondary curves and a moderate increase in the T1-T12 distance but has no impact on sagittal balance and other radiological parameters. The post-operative complication rate is particularly high in patients at risk of complications.CONCLUSIONFinal fusion after MCGR provides satisfactory additional correction of the main and secondary curves and a moderate increase in the T1-T12 distance but has no impact on sagittal balance and other radiological parameters. The post-operative complication rate is particularly high in patients at risk of complications.Level 4.LEVEL OF EVIDENCELevel 4. PurposeThe aim of this study was to evaluate the effects of definitive arthrodesis on frontal and sagittal spine balance in EOS patients treated with MCGR, as well as the complications associated with this procedure and the outcome at last follow-up.MethodsThis was a multicentre study in 10 French centres. All patients who underwent posterior spinal arthrodesis after completion of MCGR treatment, regardless of age, etiology of scoliosis between 2011 and 2022, were included.ResultsA total of 66 patients who had a final fusion after the lengthening programme were included in the study. The mean follow-up time was 5.5 ± 1.7 years (range: 2.1–9). The mean follow-up time after arthrodesis was 24 ± 18 months (range: 3–68) and the mean age at arthrodesis was 13.5 ± 1.5 years (range: 9.5–17). The main and secondary curves were significantly (p < 0.005 and p = 0.03) improved by arthrodesis (16.4° and 9° respectively) and stabilised at the last follow-up. The T1-T12 and T1-S1 distances increased by 8.4 mm and 14 mm with spinal fusion, with no significant difference (p = 0.096 and p = 0.068). There was no significant improvement in the rest of the parameters with arthrodesis, nor was there any significant deterioration at last follow-up.After final fusion, there were a total of 24 complications in 18 patients (27.3%) that routinely led to repeat surgery. ConclusionFinal fusion after MCGR provides satisfactory additional correction of the main and secondary curves and a moderate increase in the T1-T12 distance but has no impact on sagittal balance and other radiological parameters. The post-operative complication rate is particularly high in patients at risk of complications.Level of evidence Level 4. The aim of this study was to evaluate the effects of definitive arthrodesis on frontal and sagittal spine balance in EOS patients treated with MCGR, as well as the complications associated with this procedure and the outcome at last follow-up. This was a multicentre study in 10 French centres. All patients who underwent posterior spinal arthrodesis after completion of MCGR treatment, regardless of age, etiology of scoliosis between 2011 and 2022, were included. A total of 66 patients who had a final fusion after the lengthening programme were included in the study. The mean follow-up time was 5.5 ± 1.7 years (range: 2.1-9). The mean follow-up time after arthrodesis was 24 ± 18 months (range: 3-68) and the mean age at arthrodesis was 13.5 ± 1.5 years (range: 9.5-17). The main and secondary curves were significantly (p < 0.005 and p = 0.03) improved by arthrodesis (16.4° and 9° respectively) and stabilised at the last follow-up. The T1-T12 and T1-S1 distances increased by 8.4 mm and 14 mm with spinal fusion, with no significant difference (p = 0.096 and p = 0.068). There was no significant improvement in the rest of the parameters with arthrodesis, nor was there any significant deterioration at last follow-up. After final fusion, there were a total of 24 complications in 18 patients (27.3%) that routinely led to repeat surgery. Final fusion after MCGR provides satisfactory additional correction of the main and secondary curves and a moderate increase in the T1-T12 distance but has no impact on sagittal balance and other radiological parameters. The post-operative complication rate is particularly high in patients at risk of complications. Level 4. Purpose The aim of this study was to evaluate the effects of definitive arthrodesis on frontal and sagittal spine balance in EOS patients treated with MCGR, as well as the complications associated with this procedure and the outcome at last follow-up. Methods This was a multicentre study in 10 French centres. All patients who underwent posterior spinal arthrodesis after completion of MCGR treatment, regardless of age, etiology of scoliosis between 2011 and 2022, were included. Results A total of 66 patients who had a final fusion after the lengthening programme were included in the study. The mean follow-up time was 5.5 ± 1.7 years (range: 2.1–9). The mean follow-up time after arthrodesis was 24 ± 18 months (range: 3–68) and the mean age at arthrodesis was 13.5 ± 1.5 years (range: 9.5–17). The main and secondary curves were significantly ( p < 0.005 and p = 0.03) improved by arthrodesis (16.4° and 9° respectively) and stabilised at the last follow-up. The T1-T12 and T1-S1 distances increased by 8.4 mm and 14 mm with spinal fusion, with no significant difference ( p = 0.096 and p = 0.068). There was no significant improvement in the rest of the parameters with arthrodesis, nor was there any significant deterioration at last follow-up. After final fusion, there were a total of 24 complications in 18 patients (27.3%) that routinely led to repeat surgery. Conclusion Final fusion after MCGR provides satisfactory additional correction of the main and secondary curves and a moderate increase in the T1-T12 distance but has no impact on sagittal balance and other radiological parameters. The post-operative complication rate is particularly high in patients at risk of complications. Level of evidence Level 4. PurposeThe aim of this study was to evaluate the effects of definitive arthrodesis on frontal and sagittal spine balance in EOS patients treated with MCGR, as well as the complications associated with this procedure and the outcome at last follow-up.MethodsThis was a multicentre study in 10 French centres. All patients who underwent posterior spinal arthrodesis after completion of MCGR treatment, regardless of age, etiology of scoliosis between 2011 and 2022, were included.ResultsA total of 66 patients who had a final fusion after the lengthening programme were included in the study. The mean follow-up time was 5.5 ± 1.7 years (range: 2.1–9). The mean follow-up time after arthrodesis was 24 ± 18 months (range: 3–68) and the mean age at arthrodesis was 13.5 ± 1.5 years (range: 9.5–17). The main and secondary curves were significantly (p < 0.005 and p = 0.03) improved by arthrodesis (16.4° and 9° respectively) and stabilised at the last follow-up. The T1-T12 and T1-S1 distances increased by 8.4 mm and 14 mm with spinal fusion, with no significant difference (p = 0.096 and p = 0.068). There was no significant improvement in the rest of the parameters with arthrodesis, nor was there any significant deterioration at last follow-up.After final fusion, there were a total of 24 complications in 18 patients (27.3%) that routinely led to repeat surgery.ConclusionFinal fusion after MCGR provides satisfactory additional correction of the main and secondary curves and a moderate increase in the T1-T12 distance but has no impact on sagittal balance and other radiological parameters. The post-operative complication rate is particularly high in patients at risk of complications.Level of evidenceLevel 4.
Author	Nectoux, Eric Sales de Gauzy, Jerome Vialle, Raphael Canavese, Federico Mainard, Nicolas Fron, Damien Langlais, Tristan Saghbini, Elie
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Keywords	Early onset scoliosis Spinal growth Magnetically controlled growing rod Graduate Posterior spinal fusion
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publication-title: Bone Jt J doi: 10.1302/0301-620X.99B6.BJJ-2016-1102.R2 – volume: 14 start-page: e7 year: 2014 ident: 7834_CR5 publication-title: Spine J doi: 10.1016/j.spinee.2014.01.046 – volume: 44 start-page: 1201 year: 2019 ident: 7834_CR15 publication-title: Spine (Phila Pa 1976) doi: 10.1097/BRS.0000000000003048 – volume: 141 start-page: 1163 year: 2021 ident: 7834_CR19 publication-title: Arch Orthop Trauma Surg doi: 10.1007/s00402-020-03518-z – volume: 38 start-page: 665 year: 2013 ident: 7834_CR3 publication-title: Spine (Phila Pa 1976) doi: 10.1097/BRS.0b013e3182773560 – volume: 44 start-page: 1630 year: 2019 ident: 7834_CR30 publication-title: Spine (Phila Pa 1976) doi: 10.1097/BRS.0000000000003148 – volume: 46 start-page: E1105 year: 2021 ident: 7834_CR18 publication-title: Spine (Phila Pa 1976) doi: 10.1097/BRS.0000000000004044 – volume: 35 start-page: E1199 year: 2010 ident: 7834_CR11 publication-title: Spine (Phila Pa 1976) doi: 10.1097/BRS.0b013e3181e21b50 – volume: 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Snippet	Purpose The aim of this study was to evaluate the effects of definitive arthrodesis on frontal and sagittal spine balance in EOS patients treated with MCGR, as... The aim of this study was to evaluate the effects of definitive arthrodesis on frontal and sagittal spine balance in EOS patients treated with MCGR, as well as... PurposeThe aim of this study was to evaluate the effects of definitive arthrodesis on frontal and sagittal spine balance in EOS patients treated with MCGR, as...
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SubjectTerms	Arthrodesis Back surgery Complications Etiology Hospitals Life Sciences Medicine Medicine & Public Health Neurosurgery Original Article Orthopedics Patients Pediatrics Postoperative Scoliosis Surgical Orthopedics
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Title	Clinical and radiological results of final fusion in patients who underwent lengthening with magnetically controlled growing rods. About 66 patients with a mean follow-up of 5 years
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