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4. Bracing for juvenile idiopathic scoliosis: retrospective review from bracing to skeletal maturity

Author

Whitaker, Amanda T, Hresko, Michael Timothy, Miller, Patricia E, Verhofste, Bram P, Beling, Alexandra, Emans, John B, Karlin, Lawrence I, Hedequist, Daniel J, and Glotzbecker, Michael P

Subjects
Rehabilitation, Bioengineering, Clinical Research, Pediatric, Patient Safety, Musculoskeletal, Humans, Child, Preschool, Child, Scoliosis, Retrospective Studies, Braces, Spinal Fusion, Patient Compliance, Juvenile idiopathic scoliosis, Bracing, Non-operative treatment scoliosis, Spinal fusion, Biomedical Engineering, Clinical Sciences
Abstract

BackgroundJuvenile idiopathic scoliosis (JIS) outcomes with brace treatment are limited with poorly described bracing protocols. Between 49 and 100% of children with JIS will progress to surgery, however, young age, long follow-up, and varying treatment methods make studying this population difficult. The purpose of this study is to report the outcomes of bracing in JIS treated with a Boston brace™ and identify risk factors for progression and surgical intervention.MethodsThis is a single-center retrospective review of 175 patients with JIS who initiated brace treatment between the age of 4 and 9 years. A cohort of 140 children reached skeletal maturity; 91 children had surgery or at least 2 year follow-up after brace completion. Standard in-brace protocol for scoliosis 320° was a Boston brace for 18-20 h/day after MRI (n = 82). Family history, MRI abnormalities, comorbidities, curve type, curve magnitude, bracing duration, number of braces, compliance by report, and surgical interventions were recorded.ResultsChildren were average 7.9 years old (range 4.1-9.8) at the initiation of bracing. The Boston brace™ was prescribed in 82 patients and nine used night bending brace. Mid-thoracic curves (53%) was the most frequent deformity. Maximum curve at presentation was on average 30 ± 9 degrees, in-brace curve angle was 16 ± 8 degrees, and in-brace correction was 58 ± 24 percent. Patients were braced an average of 4.6 ± 1.9 years. 61/91 (67%) went on to posterior spinal fusion at 13.3 ± 2.1 (range 9.3-20.9) years and curve magnitude of 61 ± 12 degrees. Of those that underwent surgery, 49/55 (86%) progressed > 10°, 6/55 (11%) stabilized within 10°, and 0/55 (0%) improved > 10° with brace wear. No children underwent growth-friendly posterior instrumentation. Of the 28 who did not have surgical correction, 3 (11%) progressed > 10°, 13/28 (46%) stabilized within 10°, and 12/28 (43%) improved > 10° with brace wear.ConclusionsThis large series of JIS patients with bracing followed to skeletal maturity with long-term follow-up. Surgery was avoided in 33% of children with minimal to no progression, and no child underwent posterior growth-friendly constructs. Risk factors of needing surgery were noncompliance and larger curves at presentation.

Published
2022

9. A Journey from the Past to the Future

Author

Yazici, Muharrem, Akbarnia, Behrooz A., Thompson, George H., El-Hawary, Ron, Emans, John B., Akbarnia, Behrooz A., editor, Thompson, George H., editor, Yazici, Muharrem, editor, and El-Hawary, Ron, editor

Published
2022
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16. Lengthening Behavior of Magnetically Controlled Growing Rods in Early-Onset Scoliosis: A Multicenter Study

Author

Heyer, Jessica H., Anari, Jason B., Baldwin, Keith D., Mitchell, Stuart L., Luhmann, Scott J., Sturm, Peter F., Flynn, John M., Cahill, Patrick J., Abdulfattah Abdullah, Abdullah Saad, Ahn, Edward, Akbarnia, Behrooz, Akoto, Harry, Albanese, Stephen, Anari, Jason, Anderson, John, Anderson, Richard, Andras, Lindsay, Bauer, Jennifer, Bellaire, Laura, Betz, Randy, Birch, Craig, Blakemore, Laurel, Boachie-Adjei, Oheneba, Bonfield, Chris, Bouton, Daniel, Brassard, Felix, Brockmeyer, Douglas, Brooks, Jaysson, Bumpass, David, Cahill, Pat, Chemaly, Olivier, Cheung, Jason, Cheung, Kenneth, Cho, Robert, Christman, Tyler, Beauchamp, Eduardo Colom, Couture, Daniel, Crawford, Haemish, Crawford, Alvin, Dahl, Benny, Demirkiran, Gokhan, Devito, Dennis, Diab, Mohammad, El Sebaie, Hazem, El-Hawary, Ron, Emans, John, Erickson, Mark, Fabregas, Jorge, Farley, Frances, Farrington, David, Fedorak, Graham, Fitzgerald, Ryan, Fletcher, Nicholas, Floccari, Lorena, Flynn, Jack, Gabos, Peter, Gardner, Adrian, Garg, Sumeet, Gerow, Frank, Glotzbecker, Michael, Gomez, Jaime, Gonda, David, Guillaume, Tenner, Gupta, Purnendu, Halvorson, Kyle, Hammerberg, Kim, Hardesty, Christina, Hedequist, Daniel, Heffernan, Michael, Heflin, John, Helenius, Ilkka, Herrera, Jose, Hogue, Grant, Holt, Josh, Howard, Jason, Hresko, Michael Timothy, Hwang, Steven, Ihnow, Stephanie, Ilharreborde, Brice, Illingworth, Kenneth, Jain, Viral, Jea, Andrew, Johnson, Megan, Johnston, Charles, Jones, Morgan, Karlen, Judson, Karlin, Lawrence, Katz, Danielle, Kawakami, Noriaki, Kelly, Brian, Kelly, Derek, Knapp, Raymond, Koljonen, Paul, Kwan, Kenny, Labelle, Hubert, Lark, Robert, Larson, A. Noelle, Lavelle, William, Lenke, Lawrence, Lew, Sean, Li, Gertrude, Louer, Craig, Luhmann, Scott, Mac-Thiong, Jean-Marc, Mackenzie, Stuart, MacKintosh, Erin, Mangano, Francesco, Marks, David, Marquez, Sanchez, Martin, Jonathan, Martus, Jeffrey, Matamalas, Antonia, Mayer, Oscar, McCarthy, Richard, McIntosh, Amy, McQuerry, Jessica, Mehta, Jwalant, Metz, Lionel, Miller, Daniel, Miyanji, Firoz, Mundis, Greg, Murphy, Josh, Murphy, Robert, Myung, Karen, Nelson, Susan, Newton, Peter, Ede, Matthew Newton, Nguyen, Cynthia, Nunez, Susana, Oetgen, Matthew, Oswald, Timothy, Ouellet, Jean, Pahys, Josh, Palomino, Kathryn, Parent, Stefan, Garcia, Alejandro Peiro, Pellise, Ferran, Perra, Joseph, Phillips, Jonathan, Pizones, Javier, Poon, Selina, Price, Nigel, Ramirez-Lluch, Norman, Ramo, Brandon, Redding, Gregory, Ritzman, Todd, Rodriguez, Luis, Rodriguez-Olaverri, Juan Carlos, Roye, David, Roye, Benjamin, Saiman, Lisa, Samdani, Amer, Perez-Grueso, Francisco Sanchez, Sanders, James, Sawyer, Jeffrey, Sayama, Christina, Schmitz, Michael, Schulz, Jacob, Schwend, Richard, Shah, Suken, Shapiro, Jay, Shufflebarger, Harry, Skaggs, David, Smit, Kevin, Smith, John, Snyder, Brian, Sponseller, Paul, Stephen, George, Stone, Joe, Sturm, Peter, Sukkarieh, Hamdi, Swarup, Ishaan, Szczodry, Michal, Thometz, John, Thompson, George, Tomoko, Tanaka, Truong, Walter, Vialle, Raphael, Vitale, Michael, Vorhies, John, Wall, Eric, Wang, Shengru, Warner, Bill, Weinstein, Stuart, Welborn, Michelle, White, Klane, Wrubel, David, Wu, Nan, Yankey, Kwadwo, Yaszay, Burt, Yazici, Muharrem, and Zhang, Terry Jianguo

Published
2022
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20. Incidence of Parental Requests to Discontinue Growth-Friendly Surgical Lengthening for Early Onset Scoliosis.

Author

Robertson, Emily, Murphy, Robert F., Anari, Jason B., Emans, John B., Sponseller, Paul D., Samdani, Amer F., Smith, John T., Barfield, William R., and Mooney III, James F.

Subjects
OPERATIVE surgery, SCOLIOSIS, SPINE, ORTHOPEDICS, QUESTIONNAIRES
Abstract

Background: The STOP questionnaire was developed to document reasons for discontinuation of growth-friendly (GF) treatment in early onset scoliosis (EOS). This study investigated the incidence of parental request (PR) on the STOP questionnaire and compared clinical information and Early Onset Scoliosis 24-Item Questionnaire (EOSQ-24) scores of PR patients with those whose parents did not request discontinuation (non-parent request [NPR]). Materials and Methods: An international pediatric spine registry was queried for EOS patients with STOP questionnaires completed by their surgeon. Age at discontinuation, sex, and EOS etiology were recorded. GF device, number of surgical procedures, complications, STOP questionnaire reasons for discontinuation, and definitive treatment were recorded. EOSQ-24 scores and clinical information in the PR cohort were compared with the NPR cohort. Results: Data for 1326 patients were analyzed. PR was listed on the STOP questionnaires of 46 (3.5%) patients, completed at a mean age of 12 years (SD, 3.2 years). There were no statistical differences in number of procedures or complications when comparing the PR cohort with the NPR cohort. PR patients more frequently had neuromuscular EOS (P=.002), more frequently were treated with magnetically controlled growing rods (33% vs 14%, P=.036), and more frequently were observed after GF discontinuation (P=.628). EOSQ-24 scores for the PR cohort were significantly lower in most domains except pain/discomfort. Conclusion: For 3.5% of the EOS patients, PR was listed on the STOP questionnaire. They frequently had neuromuscular EOS and frequently were treated with magnetically controlled growing rods. Additionally, these patients had statistically lower EOSQ-24 scores across most domains. [Orthopedics. 2024;47(6):e311–e316.] [ABSTRACT FROM AUTHOR]

Published
2024
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