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Comparison of Percentile Weight Gain of Growth-Friendly Constructs in Early-Onset Scoliosis.
Spine Deform 2018; 6(1):43-47SD

Abstract

STUDY DESIGN

Multicenter retrospective cohort.

OBJECTIVE

To compare improvement in nutritional status seen in early-onset scoliosis (EOS) patients following treatment with various growth-friendly techniques, especially in underweight patients (<20th weight percentile).

BACKGROUND

Thoracic insufficiency resulting from EOS can lead to severe cardiopulmonary disease. In this age group, pulmonary function tests are often difficult or impossible to perform. Weight gain has been used in prior studies as a proxy for improvement and has been demonstrated following VEPTR and growing rod implantation. In this study, we aim to analyze weight gain of EOS patients treated with four different spinal implants to evaluate if significant differences in weight percentile change exist between them.

METHODS

Retrospective review of patients treated surgically for EOS was performed from a multicenter database. Exclusion criteria were index instrumentation at >10 years old and <2 years' follow-up.

RESULTS

287 patients met the inclusion criteria and etiologies were as follows: congenital = 85; syndromic = 79; neuromuscular = 69; and idiopathic = 52. Average patient age at surgery was 5.41 years, with an average follow-up of 5.8 years. Preoperatively, 55.4% (162/287) fell below the 20th weight percentile. There was no significant difference in preoperative weight between implants (p = .77), or diagnoses (p = .25). Among this group, the mean change in weight percentile was 10.5% (range: -16.7% to 88.7%) and all implant groups increased in mean weight percentile at final follow-up. There were no significant differences in weight percentile change between the groups when divided by implant type (p = .17).

CONCLUSIONS

Treatment of EOS with growth-friendly constructs resulted in an increase in weight percentile for underweight patients (<20th percentile), with no significant difference between constructs.

LEVEL OF EVIDENCE

Level III.

Authors+Show Affiliations

Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA.Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA.Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD 21218, USA.Department of Orthopaedic Surgery, Texas Scottish Rite Hospital for Children, 2222 Welborn St, Dallas, TX 75219, USA.Department of Orthopaedic Surgery, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA.Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA. Electronic address: dskaggs@chla.usc.edu.Growing Spine Study Group, Growing Spine Foundation, 555 East Wells Street, Suite 1100, Milwaukee, WI 53202, USA.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

29287816

Citation

Harris, Liam R., et al. "Comparison of Percentile Weight Gain of Growth-Friendly Constructs in Early-Onset Scoliosis." Spine Deformity, vol. 6, no. 1, 2018, pp. 43-47.
Harris LR, Andras LM, Sponseller PD, et al. Comparison of Percentile Weight Gain of Growth-Friendly Constructs in Early-Onset Scoliosis. Spine Deform. 2018;6(1):43-47.
Harris, L. R., Andras, L. M., Sponseller, P. D., Johnston, C. E., Emans, J. B., & Skaggs, D. L. (2018). Comparison of Percentile Weight Gain of Growth-Friendly Constructs in Early-Onset Scoliosis. Spine Deformity, 6(1), pp. 43-47. doi:10.1016/j.jspd.2017.05.005.
Harris LR, et al. Comparison of Percentile Weight Gain of Growth-Friendly Constructs in Early-Onset Scoliosis. Spine Deform. 2018;6(1):43-47. PubMed PMID: 29287816.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of Percentile Weight Gain of Growth-Friendly Constructs in Early-Onset Scoliosis. AU - Harris,Liam R, AU - Andras,Lindsay M, AU - Sponseller,Paul D, AU - Johnston,Charles E, AU - Emans,John B, AU - Skaggs,David L, AU - ,, PY - 2017/01/04/received PY - 2017/05/19/revised PY - 2017/05/21/accepted PY - 2017/12/31/entrez PY - 2017/12/31/pubmed PY - 2019/1/16/medline KW - Early-onset scoliosis KW - Growing rod KW - Growth-friendly construct KW - Guided growth KW - Malnutrition KW - Nutrition KW - VEPTR KW - Weight gain SP - 43 EP - 47 JF - Spine deformity JO - Spine Deform VL - 6 IS - 1 N2 - STUDY DESIGN: Multicenter retrospective cohort. OBJECTIVE: To compare improvement in nutritional status seen in early-onset scoliosis (EOS) patients following treatment with various growth-friendly techniques, especially in underweight patients (<20th weight percentile). BACKGROUND: Thoracic insufficiency resulting from EOS can lead to severe cardiopulmonary disease. In this age group, pulmonary function tests are often difficult or impossible to perform. Weight gain has been used in prior studies as a proxy for improvement and has been demonstrated following VEPTR and growing rod implantation. In this study, we aim to analyze weight gain of EOS patients treated with four different spinal implants to evaluate if significant differences in weight percentile change exist between them. METHODS: Retrospective review of patients treated surgically for EOS was performed from a multicenter database. Exclusion criteria were index instrumentation at >10 years old and <2 years' follow-up. RESULTS: 287 patients met the inclusion criteria and etiologies were as follows: congenital = 85; syndromic = 79; neuromuscular = 69; and idiopathic = 52. Average patient age at surgery was 5.41 years, with an average follow-up of 5.8 years. Preoperatively, 55.4% (162/287) fell below the 20th weight percentile. There was no significant difference in preoperative weight between implants (p = .77), or diagnoses (p = .25). Among this group, the mean change in weight percentile was 10.5% (range: -16.7% to 88.7%) and all implant groups increased in mean weight percentile at final follow-up. There were no significant differences in weight percentile change between the groups when divided by implant type (p = .17). CONCLUSIONS: Treatment of EOS with growth-friendly constructs resulted in an increase in weight percentile for underweight patients (<20th percentile), with no significant difference between constructs. LEVEL OF EVIDENCE: Level III. SN - 2212-1358 UR - https://www.unboundmedicine.com/medline/citation/29287816/Comparison_of_Percentile_Weight_Gain_of_Growth_Friendly_Constructs_in_Early_Onset_Scoliosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2212-134X(16)30112-5 DB - PRIME DP - Unbound Medicine ER -