The potential of spring distraction to dynamically correct complex spinal deformities in the growing child
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ORIGINAL ARTICLE
The potential of spring distraction to dynamically correct complex spinal deformities in the growing child Sebastiaan P. J. Wijdicks1 · Justin V. C. Lemans1 · Gijsbertus J. Verkerke2,3 · Herke Jan Noordmans4 · René M. Castelein1 · Moyo C. Kruyt1 Received: 16 June 2020 / Revised: 26 August 2020 / Accepted: 20 September 2020 © The Author(s) 2020
Abstract Purpose Current treatment of progressive early onset scoliosis involves growth-friendly instrumentation if conservative treatment fails. These implants guide growth by passive sliding or repeated lengthenings. None of these techniques provide dynamic correction after implantation. We developed the spring distraction system (SDS), by using one or multiple compressed springs positioned around a standard sliding rod, to provide active continuous distraction of the spine to stimulate growth and further correction. The purpose of this study was to determine feasibility and proof of concept of the SDS. Methods We developed a versatile, dynamic spring distraction system for patients who would benefit from active continuous distraction. This prospective case series evaluates four patients with exceptional and progressive congenital spine deformities. Results Four patients had a mean age of 6.8 years at surgery with a mean follow-up of 36 months (range 25–45). The mean progressive thoracic lordosis, which was the reason for initiating surgical treatment in two patients, changed from 32° lordosis preoperatively to 1° kyphosis post-operatively. During follow-up, this further improved to 32° thoracic kyphosis. In the two other patients, with cervicothorcacic scoliosis, the main coronal curve improved from 79° pre-operatively to 56° post-operatively and further improved to 42°. The mean T1-S1 spine growth during follow-up for all patients was 1.3 cm/ year. There was one reoperation because of skin problems and no device-failures. Conclusion These early results show the feasibility and the proof of concept of spring-based distraction as a dynamic growthenhancing system with the potential of further correction of the deformity after implantation. Keywords Dynamic growth enhancing correction · Innovative device · Growing rods · Spring distraction · Early onset scoliosis
* Moyo C. Kruyt [email protected] Sebastiaan P. J. Wijdicks [email protected] Justin V. C. Lemans j.v.c.lemans‑[email protected] Gijsbertus J. Verkerke [email protected] Herke Jan Noordmans [email protected] René M. Castelein [email protected]
1
Department of Orthopaedic Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
2
Department of Biomechanical Engineering, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands
3
Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
4
Department of Medical Technology and Clinical Physics, University Medical Center Utrecht, Hei
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