Are final fusions for scoliosis patients treated with growing rods actually final? 5 key notes

Spine

A new study published in the Journal of Bone and Joint Surgery examined adolescent scoliosis patients who underwent treatment with the use of growing rods to determine whether their last planned fusion was actually the final fusion.

The researchers examined a multicenter database of patients with early onset scoliosis that followed patients treated with growing rods for at least two years. There were 119 patients included in the study with 38 who reported neuromuscular scoliosis, 31 with syndromatic scoliosis, 22 with idiopathic scoliosis and nine with congenital scoliosis.

 

The researchers found:

 

1. There was an average of 1.5 complications per patient after the final fusion.

 

2. There were 30 complications in 20 percent of the patients that required reoperation, leading to 57 additional procedures.

 

3. There were eight patients with neuromuscular scoliosis, eight with syndromatic scoliosis and four with idiopathic scoliosis that required reoperation. None of the patients with congenital scoliosis required reoperations.

 

4. The complications included:

 

• Infections: 9 percent — leading to 33 reoperation procedures
• Instrumentation failure: 6 percent — leading to eight reoperation procedures
• Painful or prominent instrumentation: 5 percent — leading to six reoperation procedures
• Coronal deformity: 3 percent — leading to three procedures
• Pseudarthrosis: 3 percent — leading to three reoperation procedures
• Sagittal deformity: 3 percent — leading to three reoperation procedures
• Progressive crankshaft chest wall deformity requiring a thoracoplasty: 1 percent — leading to one reoperation procedure

 

5. The researchers concluded there were higher-than-anticipated percentages of unplanned reoperations after the final fusion in patients treated with growing rods.

 

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