A comparison of three-and two-rod constructs in the correction of severe pediatric scoliosis

dc.contributor.author

Machida, M

dc.contributor.author

Rocos, B

dc.contributor.author

Zeller, R

dc.contributor.author

Lebel, DE

dc.date.accessioned

2024-01-10T15:12:59Z

dc.date.available

2024-01-10T15:12:59Z

dc.date.issued

2023-04-01

dc.description.abstract

Purpose: Managing severe scoliosis is challenging and risky with a significant complication rate regardless of treatment strategy. In this retrospective comparative study, we report our results using a three-rod compared to two-rod construct in the surgical treatment of severe spine deformities to investigate which technique is safer, and which provides superior radiological outcomes. Methods: Forty-six consecutive patients undergoing posterior spine fusion for scoliosis between 2006 and 2017 were identified in our institutional records. Inclusion criteria were minimum coronal deformity of 90°, age < 18 years at the time of surgery and a minimum 2 years of follow-up. Radiographic and clinical parameters, as well as post-operative complications were compared between the two groups. Results: There were 21 patients in the three-rod group and 25 in the two-rod group. The mean preoperative major coronal deformity was 100°± 9 and 102°± 10 in the three-rod and two-rod, respectively (p = 0.6). The average major curve correction was 51% and 59% in three-rod and two-rod groups, respectively (p = 0.03). The post-operative thoracic kyphosis was 30°± 11 and 21°± 12 in the three-rod and the two-rod groups, respectively (p = 0.01). The surgical time was 476 ± 52 and 387 ± 84 min in three-rod and two-rod, respectively (p < 0.01). One patient in the two-rod cohort showed permanent post-operative sensory deficit. There were three unplanned returns to operating theater in the two-rod group. Conclusions: Coronal correction was better with two-rod, whereas sagittal balance was superior with three-rod. Both techniques achieved balanced spine treating severe scoliosis. The two-rod technique was associated with a higher likelihood of requiring revision surgery. Level of evidence: level 3.

dc.identifier.issn

1863-2521

dc.identifier.issn

1863-2548

dc.identifier.uri

https://hdl.handle.net/10161/29685

dc.language

en

dc.publisher

SAGE Publications

dc.relation.ispartof

Journal of Children's Orthopaedics

dc.relation.isversionof

10.1177/18632521231156438

dc.rights.uri

https://creativecommons.org/licenses/by-nc/4.0

dc.title

A comparison of three-and two-rod constructs in the correction of severe pediatric scoliosis

dc.type

Journal article

duke.contributor.orcid

Rocos, B|0000-0002-0808-5585

pubs.begin-page

148

pubs.end-page

155

pubs.issue

2

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Orthopaedic Surgery

pubs.organisational-group

Neurosurgery

pubs.publication-status

Published

pubs.volume

17

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