Growth-Friendly Implants With Rib Clawing Hooks as Proximal Anchors in Early-Onset Scoliosis.

Azmi Ahmad, Alaaeldin; Aker, Loai; Hanbali, Yahia; Arafat, Yousef · Global Spine J · 2020

retrospective_cohort · Level III

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Abstract

Retrospective study. This study retrospectively evaluates the outcome of the surgical treatment of early-onset scoliosis with proximal clawing rib fixation in hybrid growing-rod constructs. The study examines spinal deformity correction with spinal growth maintenance, and the complications associated with this technique. A hybrid rib construct surgery with serial lengthening was utilized for the treatment of 71 patients. Mean age at surgery was 66.6 months and mean time for follow-up was 43.9 months. The coronal Cobb angle in patients fell from 63.1° preoperatively to 51.6° at the last follow-up, with a correction of 16.8%. The sagittal Cobb angle fell from 66.7° preoperatively to 38° at the last follow-up, with a correction of 42.6%. Coronal balance fell from 22.8° preoperatively to 22.3°, and sagittal balance fell from 35.4 mm preoperatively to 24.39 mm. T1-S1 spine height increased from 248.7 mm preoperatively to 282.4 mm, with a mean change of 1.13 cm per year. No neurological complications were detected. Surgical management for early-onset scoliosis using proximal clawing rib fixation technique is a good choice in terms of safety, ease of placing the proximal anchors, ability to use more than one form of instrumentation, and a lower complication rate.