Endoscopic mechanical spinal hemiepiphysiodesis modifies spine growth.

Area of Science:

• Orthopedics
• Spine Surgery
• Animal Models

Background:

• Staple hemiepiphysiodesis is used for knee deformities but has failed for spinal deformities.
• Spine growth is modifiable, but no clinically translatable method consistently alters vertebral growth.
• Previous attempts to correct spinal deformities with similar procedures have been unsuccessful.

Purpose of the Study:

• To test if scoliotic curvatures can be created using anatomically based vertebral staples.
• To evaluate a proposed method of early surgical treatment for spinal deformities.
• To investigate the potential of minimally invasive techniques in altering spine growth.

Main Methods:

• An in vivo porcine model of progressive scoliosis was developed.
• Custom spine staples were implanted into midthoracic vertebrae of skeletally immature pigs.
• Radiography was used to measure coronal plane curvatures (Cobb angles) over an 8-week period.

Main Results:

• Coronal plane curvatures significantly increased from 0.8 to 22.4 degrees (P = 0.0001) in 8 weeks.
• Five of seven pigs completed the study protocol.
• Sagittal plane curvatures did not show a significant increase over time.

Conclusions:

• Spinal hemiepiphysiodesis with an anatomically based implant and minimally invasive procedures successfully induced spine curvature in a porcine model.
• These techniques show potential for slowing or correcting early progressive spine deformity.
• The method may offer an alternative to long rod instrumentation or fusion for spinal deformities.