TY - JOUR
T1 - The potential of spring distraction to dynamically correct complex spinal deformities in the growing child
AU - Wijdicks, Sebastiaan P J
AU - Lemans, Justin V C
AU - Verkerke, Gijsbertus J
AU - Noordmans, Herke Jan
AU - Castelein, René M
AU - Kruyt, Moyo C
N1 - Publisher Copyright:
© 2020, The Author(s).
PY - 2021/3
Y1 - 2021/3
N2 - PURPOSE: Current treatment of progressive early onset scoliosis involves growth-friendly instrumentation if conservative treatment fails. These implants guide growth by passive sliding or repeated lengthenings. None of these techniques provide dynamic correction after implantation. We developed the spring distraction system (SDS), by using one or multiple compressed springs positioned around a standard sliding rod, to provide active continuous distraction of the spine to stimulate growth and further correction. The purpose of this study was to determine feasibility and proof of concept of the SDS.METHODS: We developed a versatile, dynamic spring distraction system for patients who would benefit from active continuous distraction. This prospective case series evaluates four patients with exceptional and progressive congenital spine deformities.RESULTS: Four patients had a mean age of 6.8 years at surgery with a mean follow-up of 36 months (range 25-45). The mean progressive thoracic lordosis, which was the reason for initiating surgical treatment in two patients, changed from 32° lordosis preoperatively to 1° kyphosis post-operatively. During follow-up, this further improved to 32° thoracic kyphosis. In the two other patients, with cervicothorcacic scoliosis, the main coronal curve improved from 79° pre-operatively to 56° post-operatively and further improved to 42°. The mean T1-S1 spine growth during follow-up for all patients was 1.3 cm/year. There was one reoperation because of skin problems and no device-failures.CONCLUSION: These early results show the feasibility and the proof of concept of spring-based distraction as a dynamic growth-enhancing system with the potential of further correction of the deformity after implantation.
AB - PURPOSE: Current treatment of progressive early onset scoliosis involves growth-friendly instrumentation if conservative treatment fails. These implants guide growth by passive sliding or repeated lengthenings. None of these techniques provide dynamic correction after implantation. We developed the spring distraction system (SDS), by using one or multiple compressed springs positioned around a standard sliding rod, to provide active continuous distraction of the spine to stimulate growth and further correction. The purpose of this study was to determine feasibility and proof of concept of the SDS.METHODS: We developed a versatile, dynamic spring distraction system for patients who would benefit from active continuous distraction. This prospective case series evaluates four patients with exceptional and progressive congenital spine deformities.RESULTS: Four patients had a mean age of 6.8 years at surgery with a mean follow-up of 36 months (range 25-45). The mean progressive thoracic lordosis, which was the reason for initiating surgical treatment in two patients, changed from 32° lordosis preoperatively to 1° kyphosis post-operatively. During follow-up, this further improved to 32° thoracic kyphosis. In the two other patients, with cervicothorcacic scoliosis, the main coronal curve improved from 79° pre-operatively to 56° post-operatively and further improved to 42°. The mean T1-S1 spine growth during follow-up for all patients was 1.3 cm/year. There was one reoperation because of skin problems and no device-failures.CONCLUSION: These early results show the feasibility and the proof of concept of spring-based distraction as a dynamic growth-enhancing system with the potential of further correction of the deformity after implantation.
KW - Dynamic growth enhancing correction
KW - Early onset scoliosis
KW - Growing rods
KW - Innovative device
KW - Spring distraction
UR - http://www.scopus.com/inward/record.url?scp=85092099785&partnerID=8YFLogxK
U2 - 10.1007/s00586-020-06612-3
DO - 10.1007/s00586-020-06612-3
M3 - Article
C2 - 33025194
SN - 0940-6719
VL - 30
SP - 714
EP - 723
JO - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
JF - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
IS - 3
ER -