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Early Definitive Fusion Versus Magnetic Growing Rods in "Tweeners": What Do Parents Prefer?
Sylvia Culpepper1,2, Ravi Rajendra1, Brett Lullo3
1Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center.
Journal of Pediatric Orthopedics
|September 15, 2025
Summary
Parents of children with early-onset scoliosis (EOS) prioritize minimizing complications and surgeries. Choice-based conjoint analysis reveals a strong preference for posterior spinal fusion (PSF) over magnetically controlled growing rods (MCGR) in surgical decision-making.
Area of Science:
- Pediatric Orthopaedics
- Spine Surgery
- Decision Science
Background:
- Early-onset scoliosis (EOS) treatment involves a choice between growth-friendly interventions like magnetically controlled growing rods (MCGR) and definitive posterior spinal fusion (PSF).
- Understanding family preferences is crucial for shared decision-making (SDM) in EOS treatment, yet specific parental priorities are not well-documented.
Purpose of the Study:
- To investigate parental preferences for different surgical attributes in early-onset scoliosis treatment.
- To compare parent preferences between magnetically controlled growing rods (MCGR) and posterior spinal fusion (PSF) using choice-based conjoint (CBC) analysis.
Main Methods:
- A choice-based conjoint (CBC) analysis was conducted using Sawtooth Software with 432 US-based participants aged 18+ with children aged 8-9.
- The Hierarchical Bayes (HB) method analyzed preferences for curve correction, spinal height increase, total surgeries, treatment duration, and complication risk.
- Participants were recruited via the Prolific crowdsourcing platform.
Main Results:
- Participants prioritized minimizing complications (37%), followed by the total number of surgeries (22%), and curve correction (21%).
- Female participants and those with daughters placed higher importance on the total number of surgeries.
- Simulator analysis indicated an 86.6% hypothetical preference for posterior spinal fusion (PSF) over magnetically controlled growing rods (MCGR) (13.4%).
Conclusions:
- Parents of children with EOS undergoing surgical intervention prioritize complication reduction, fewer surgeries, and effective curve correction, favoring PSF.
- Child's and parent's sex significantly influenced attribute preferences, highlighting demographic impacts on treatment choice.
- Choice-based conjoint (CBC) analysis effectively elucidates family priorities, enhancing SDM in pediatric orthopaedic surgery.
