TY - JOUR
T1 - Use of a distraction-to-stall lengthening procedure in magnetically controlled growing rods
T2 - A single-center cohort study
AU - Dahl, Benny
AU - Dragsted, Casper
AU - Ohrt-Nissen, Søren
AU - Andersen, Thomas
AU - Gehrchen, Martin
PY - 2018/5
Y1 - 2018/5
N2 - Purpose: The objective of this study was to assess the outcome of patients treated with magnetically controlled growing rods (MCGRs) using a standardized distraction procedure with intended distraction-to-stall and to compare the outcomes between idiopathic and nonidiopathic patients. Methods: This was a retrospective single-center cohort study. Conversion cases were excluded. Distractions were performed with 2-to 3-month intervals with the intention of distraction-to-stall on both rods. Distraction length was measured on X-rays every 6 months. Spinal height was assessed using T1-T12 and T1-S1 annual increase. Results: 19 patients (eight idiopathic and 11 nonidiopathic) were included. Mean age at surgery was 9.7 ± 1.9 years, and median follow-up was 1.9 years (interquartile range (IQR): 1.3–2.2). Major curve improved from median 76° (IQR: 64–83) preoperatively to 42° (IQR: 32–51) postoperatively (p < 0.001) corresponding to a curve correction of 43% (IQR: 33–51). Correction was maintained at 1-and 2-year follow-up. Median annual T1-T12 and T1-S1 height increase were 10 mm (IQR: 6–16) and 11 mm (IQR: 7–33), respectively. A total of 159 distraction procedures were performed; 83.5% of these were distracted-to-stall, and 16.5% were stopped due to discomfort. Median rod distraction per procedure was 2.0 mm (IQR: 1.6–2.7) for the concave side and 1.7 mm (IQR: 1.4–2.5) for the convex side. Five patients had implant-related complications. Patients with nonidiopathic etiology were significantly younger and had lower flexibility compared with idiopathic patients (p = 0.040). However, we found no statistically significant difference in curve correction, spinal height increase, distraction length, or complications between the two groups (p = 0.109). Conclusion: MCGR effectively corrected the deformity and increased spinal height using a distraction procedure with intended distraction-to-stall. Five of 19 patients had implant-related complications, and we found no difference in the outcomes between idiopathic and nonidiopathic patients.
AB - Purpose: The objective of this study was to assess the outcome of patients treated with magnetically controlled growing rods (MCGRs) using a standardized distraction procedure with intended distraction-to-stall and to compare the outcomes between idiopathic and nonidiopathic patients. Methods: This was a retrospective single-center cohort study. Conversion cases were excluded. Distractions were performed with 2-to 3-month intervals with the intention of distraction-to-stall on both rods. Distraction length was measured on X-rays every 6 months. Spinal height was assessed using T1-T12 and T1-S1 annual increase. Results: 19 patients (eight idiopathic and 11 nonidiopathic) were included. Mean age at surgery was 9.7 ± 1.9 years, and median follow-up was 1.9 years (interquartile range (IQR): 1.3–2.2). Major curve improved from median 76° (IQR: 64–83) preoperatively to 42° (IQR: 32–51) postoperatively (p < 0.001) corresponding to a curve correction of 43% (IQR: 33–51). Correction was maintained at 1-and 2-year follow-up. Median annual T1-T12 and T1-S1 height increase were 10 mm (IQR: 6–16) and 11 mm (IQR: 7–33), respectively. A total of 159 distraction procedures were performed; 83.5% of these were distracted-to-stall, and 16.5% were stopped due to discomfort. Median rod distraction per procedure was 2.0 mm (IQR: 1.6–2.7) for the concave side and 1.7 mm (IQR: 1.4–2.5) for the convex side. Five patients had implant-related complications. Patients with nonidiopathic etiology were significantly younger and had lower flexibility compared with idiopathic patients (p = 0.040). However, we found no statistically significant difference in curve correction, spinal height increase, distraction length, or complications between the two groups (p = 0.109). Conclusion: MCGR effectively corrected the deformity and increased spinal height using a distraction procedure with intended distraction-to-stall. Five of 19 patients had implant-related complications, and we found no difference in the outcomes between idiopathic and nonidiopathic patients.
U2 - 10.1177/2309499018779833
DO - 10.1177/2309499018779833
M3 - Journal article
C2 - 29871534
SN - 1022-5536
VL - 26
SP - 1
EP - 9
JO - Journal of Orthopaedic Surgery
JF - Journal of Orthopaedic Surgery
IS - 2
M1 - 2309499018779833
ER -