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The Effect of Growing Rod Treatment on Hemoglobin and Hematocrit Levels in Early-onset Scoliosis.
J Pediatr Orthop 2016; 36(6):618-20JP

Abstract

BACKGROUND

This study examines preoperative hemoglobin (Hgb) and hematocrit (Hct) levels in a group of early-onset scoliosis (EOS) patients and the effect of distraction-based growing rods (GRs) on these levels. Children with EOS are at risk for respiratory insufficiency and chronic hypoxemia. Increased Hgb and Hct levels have been identified as surrogate markers for chronic hypoxemia. A study of patients who underwent VEPTR surgery showed a significant decrease in Hgb levels following surgery.

METHODS

Data were retrospectively collected on 66 EOS patients without confounding respiratory issues or oxygen dependence who were treated with GRs at 5 institutions. Average age at initial surgery was 5.5 years. Patients were followed for a minimum of 2 years (average 3.7 y). Preoperative and postoperative Hgb and Hct levels were converted to Z-scores based on age-adjusted mean blood indices and were compared using a paired t test.

RESULTS

The prevalence of elevated Hgb and Hct levels (Z-score >2) preoperatively was 15% (10/66) and 19% (12/64), respectively. The average Hgb Z-score decreased from 0.20 to -0.31 (P=0.005) 6 to 24 months following surgery and the Hct Z-score decreased from 0.31 to -0.28 (P=0.002) 6 to 24 months following surgery.

CONCLUSIONS

Following distraction-based GR treatment of children with EOS there was a significant decrease in both their Hgb and Hct. This is a physiological marker of decreased hypoxemia and improved pulmonary function.

LEVEL OF EVIDENCE

Level III-therapeutic study.

Authors+Show Affiliations

*Children's Orthopaedic Center, Children's Hospital of Los Angeles †Department of Orthopaedics, University of California Los Angeles, Los Angeles ∥San Diego Center for Spinal Disorders, La Jolla, CA ‡Department of Orthopaedic Surgery, Texas Scottish Rite Hospital for Children, Dallas, TX §Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25944296

Citation

Barrett, Kody K., et al. "The Effect of Growing Rod Treatment On Hemoglobin and Hematocrit Levels in Early-onset Scoliosis." Journal of Pediatric Orthopedics, vol. 36, no. 6, 2016, pp. 618-20.
Barrett KK, Lee C, Myung K, et al. The Effect of Growing Rod Treatment on Hemoglobin and Hematocrit Levels in Early-onset Scoliosis. J Pediatr Orthop. 2016;36(6):618-20.
Barrett, K. K., Lee, C., Myung, K., Johnston, C., Shah, S. A., Akbarnia, B. A., & Skaggs, D. L. (2016). The Effect of Growing Rod Treatment on Hemoglobin and Hematocrit Levels in Early-onset Scoliosis. Journal of Pediatric Orthopedics, 36(6), pp. 618-20. doi:10.1097/BPO.0000000000000505.
Barrett KK, et al. The Effect of Growing Rod Treatment On Hemoglobin and Hematocrit Levels in Early-onset Scoliosis. J Pediatr Orthop. 2016;36(6):618-20. PubMed PMID: 25944296.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Effect of Growing Rod Treatment on Hemoglobin and Hematocrit Levels in Early-onset Scoliosis. AU - Barrett,Kody K, AU - Lee,Christopher, AU - Myung,Karen, AU - Johnston,Charles, AU - Shah,Suken A, AU - Akbarnia,Behrooz A, AU - Skaggs,David L, AU - ,, PY - 2015/5/7/entrez PY - 2015/5/7/pubmed PY - 2017/3/23/medline SP - 618 EP - 20 JF - Journal of pediatric orthopedics JO - J Pediatr Orthop VL - 36 IS - 6 N2 - BACKGROUND: This study examines preoperative hemoglobin (Hgb) and hematocrit (Hct) levels in a group of early-onset scoliosis (EOS) patients and the effect of distraction-based growing rods (GRs) on these levels. Children with EOS are at risk for respiratory insufficiency and chronic hypoxemia. Increased Hgb and Hct levels have been identified as surrogate markers for chronic hypoxemia. A study of patients who underwent VEPTR surgery showed a significant decrease in Hgb levels following surgery. METHODS: Data were retrospectively collected on 66 EOS patients without confounding respiratory issues or oxygen dependence who were treated with GRs at 5 institutions. Average age at initial surgery was 5.5 years. Patients were followed for a minimum of 2 years (average 3.7 y). Preoperative and postoperative Hgb and Hct levels were converted to Z-scores based on age-adjusted mean blood indices and were compared using a paired t test. RESULTS: The prevalence of elevated Hgb and Hct levels (Z-score >2) preoperatively was 15% (10/66) and 19% (12/64), respectively. The average Hgb Z-score decreased from 0.20 to -0.31 (P=0.005) 6 to 24 months following surgery and the Hct Z-score decreased from 0.31 to -0.28 (P=0.002) 6 to 24 months following surgery. CONCLUSIONS: Following distraction-based GR treatment of children with EOS there was a significant decrease in both their Hgb and Hct. This is a physiological marker of decreased hypoxemia and improved pulmonary function. LEVEL OF EVIDENCE: Level III-therapeutic study. SN - 1539-2570 UR - https://www.unboundmedicine.com/medline/citation/25944296/The_Effect_of_Growing_Rod_Treatment_on_Hemoglobin_and_Hematocrit_Levels_in_Early_onset_Scoliosis_ L2 - http://dx.doi.org/10.1097/BPO.0000000000000505 DB - PRIME DP - Unbound Medicine ER -