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A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
Published on: May 11, 2020
Instrumentation failure following pediatric spine deformity growth-sparing surgery using traditional growing rods or
Noriaki Yokogawa1, Satoru Demura2, Tetsuya Ohara3
1Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Ishikawa, Japan.
Insights
Instrumentation failure (IF) in pediatric spinal deformity surgery using traditional growing rods (TGRs) and vertical expandable prosthetic titanium ribs (VEPTRs) occurs early. Close follow-up is crucial for early detection and improved outcomes.
Area of Science:
- Pediatric Orthopedics
- Spinal Surgery
- Biomedical Engineering
Background:
- Instrumentation failure (IF) is a significant complication in pediatric spinal deformity growth-sparing surgeries.
- Limited data exists on IF incidence following specific surgical procedures like traditional growing rods (TGRs) and vertical expandable prosthetic titanium ribs (VEPTRs).
Conclusions:
- IF, including rod breakage and anchor complications, is more frequent early in lengthening surgeries.
- Findings emphasize the need for vigilant postoperative monitoring to detect IF and enhance patient outcomes.
- Early detection of IF can aid in patient counseling and improve treatment results.
Background:
Instrumentation failure (IF) is a major complication associated with growth-sparing surgery for pediatric spinal deformities; however, studies focusing on IF following each surgical procedure are lacking. We aimed to evaluate the incidence, timing, and rates of unplanned return to the operating room (UPROR) associated with IF following each surgical procedure in growth-sparing surgeries using traditional growing rods (TGRs) and vertical expandable prosthetic titanium ribs (VEPTRs).
Methods:
We reviewed 1,139 surgical procedures documented in a Japanese multicenter database from 2015 to 2017. Of these, 544 TGR and 455 VEPTR procedures were included for evaluation on a per-surgery basis. IF was defined as the occurrence of an implant-related complication requiring revision surgery.
Results:
The surgery-based incidences of IF requiring revision surgery in the TGR and VEPTR groups were 4.3% and 4.0%, respectively, with no significant intergroup difference. Remarkably, there was a negative correlation between IF incidence per surgical procedure and the number of lengthening surgeries in both groups. In addition, rod breakage in the TGR group and anchor-related complications in the VEPTR group tended to occur relatively early in the treatment course. The surgery-based rates of UPROR due to IF in the TGR and VEPTR groups were 2.0% and 1.5%, respectively, showing no statistically significant difference.
Conclusions:
We found that IF, such as anchor related-complications and rod breakage, occurs more frequently earlier in the course of lengthening surgeries. This finding may help in patient counseling and highlights the importance of close postoperative follow-up to detect IF and improve outcomes.
