Comparison of complications among growing spinal implants

Area of Science:

• Pediatric Orthopedics
• Spinal Surgery
• Biomedical Engineering

Background:

• Growing spine surgery aims to correct deformities while allowing spinal growth.
• Previous complication rates in growing spine surgery may be underestimated.
• Early-onset spinal deformities require specialized implantable devices.

Purpose of the Study:

• To evaluate and compare the complication rates of different types of growing spinal implants.
• To identify potential risk factors influencing complication rates in pediatric spinal deformity surgery.

Main Methods:

• Retrospective review of 36 children with early-onset spinal deformity treated with growing implants.
• Categorization into three groups: standard dual growing rods, hybrid growing rods, and VEPTR (vertical expandable prosthetic titanium rib).
• Complications defined as neurologic injuries, implant failure, or infection; statistical analysis performed.

Main Results:

• High overall complication rate (72% of patients), with common issues including rod breakage and anchor migration.
• Hybrid growing rods demonstrated a lower complication rate (0.86 per patient) compared to standard dual growing rods (2.3 per patient) and VEPTR (2.37 per patient).
• No significant influence of preoperative Cobb angle, kyphosis, age, or BMI on complication rates was observed.

Conclusions:

• Growing spine surgery exhibits a uniformly high complication rate, necessitating careful implant selection.
• Hybrid growing rod constructs show a promising trend towards reduced complications in pediatric spinal deformity.
• Further research is warranted to optimize implant designs and surgical techniques for improved patient outcomes.