Table 3.
Comparative results of current treatments for early-onset scoliosis
| Author | Sanders et al., 2009 [19] | Pratt et al., 1999 [18] | Akbarnia et al., 2005 [3] | Campbell et al., 2004 [5] | Hasler et al., 2010 [9] | McCarthy et al., 2009 [14] | Ouellet, 2010 (current study) |
|---|---|---|---|---|---|---|---|
| Techniques Time span |
Derotation casting 2003–2008 | Luqué Trolley and epiphysiodesis 1983–1990 | Dual growing rod 1993–2001 | VEPTR | VEPTR | Shilla Apical fusion | Modern trolley |
| Indication | 38 EOS 15 syndesmosis; 3 NM |
25 EOS | 7 EOS; 3 Cong; 2 NM; 11 Synd | 21 Cong et chest abnormality | 1 EOS; 12 NM; 0 Cong; 5 syndesmosis; 5 chest |
3 EOS; 1 Cong; 2 Synd 4 | 2 EOS; 1 NM; 2 syndesmosis |
| No. | 55 | 25 | 23 | 21 | 23 | 10 | 5 |
| Minimum and average followup | Minimum 1 year Average 2.1 years |
Minimum 5 years | Minimum 2 years Average 4.75 (2–9.25) |
Minimum 2 years Average 4.2 |
Minimum 2 years Average 3.6 years (2–5.8) |
Minimum 2 years | Minimum 2 years Average 3.6 (2–5.5) |
| Average age at initiation of treatment | 2.2 years (1.1–6) | 3.1 years (1.5–7.4) | 5.4 years (1.9–12) | 3.3 years | 6.5 years (1.1–10.5) | 7.6 years (2–10) | 6.5 years (3.8–8.5) |
| Average time of treatment | 1 year | 5 years | 4 years | Not mentioned | Not mentioned | Not mentioned | 4 years |
| Number of additional procedures (planned lengthening) | < 2 years: 2/month < 3 years: 3/month > 4 years: 4/month Cast change under GA |
13 additional procedures Average 0.5 per patient |
166 additional procedures 15 unplanned Average 6.6 per patient |
Not mentioned | 149 additional procedures 15 unplanned Average 7.1 per patient |
5 additional procedure 1 rod exchange do to overgrowth 1 prominent implants 1 rod fracture 2 I&D for infection Average 0.5 per patient |
3 add procedures 2 rod exchange due to overgrowth 1 rod revision resulting from recurrence deficiency Average 0.6 per patient |
| Number of vertebrae spanned | All | 10 (9–12) | 13 (11–17) | Not mentioned | Not mentioned | Not mentioned | 10 |
| Growth across the spine | No data | Average 2.9 cm 49% expected With epiphysiodesis Average 2.0 cm 32% expected |
Average of 4.8 cm average 1.2 cm/year |
Average 3.3 cm Average 0.8 cm/year Prior fusion Average 0.3 cm/year |
Not mentioned | Addition of 12% | Average 3 cm average per year of 0.75 cm |
| Complications | No data transient Skin irritation |
32% 8 patients with implant failure 1 infection 1 fusion 1 kyphosis |
47% 11 patients had total of 13 complications |
Not mentioned | 100% 23 complications 10 skin sloughs, 7 implant failure, 6 infection |
50% 1 prominent implants 1 rod fracture 2 I&D for infection |
40% 1 patient loss of correction, unilateral convex 4-segment fusion |
| Percent correction primary curve | ¼ > 80% ½ = 50% ¼ < 40% |
Initial correction 60% Latest followup 51% |
Initial correction 54% Latest followup 53% |
Initial correction 30% Latest followup 25% |
Initial correction 61% Latest followup 51% |
Initial correction 65% Latest followup 61% |
VEPTR = vertical expandable prosthetic titanium ribs; EOS = early-onset scoliosis; Cong = congenital scoliosis; NM = neuromuscular scoliosis.