Case Series of First Trolley Gliding Vehicle Device used in Patients with Early Onset Scoliosis as a Growth Guiding System

Abstract

IntroductionCurrent surgical treatment modalities available for the treatment of early onset scoliosis, either spine based Duel Growing Rods, or rib based VEPTR construct, require repetitive lengthening surgeries with no apical control of the deformity. The overall results of these techniques have shown to provide some benefits. However they remain with a high rate of complications, in part related to frequent repetitive surgeries. A new gliding spinal anchor know as Trolley Gliding Vehicle (TGV) and a new surgical technique has been developed with the hope to address some of these short coming. Here we present this innovative device and the new surgical technique. Material and MethodsSix patients with Early Onset Scoliosis were treated with TGV by a single surgeon at three institutions. The implant was made available via a special access program from Health Canada, as the implant is only available in Europe (CE mark). Patient perioperative data was collected for all patients. Any intra-operative or immediate post-operative complications were also documented. ResultsThe average age of the patients was 8.3 years of age. The pre-operative diagnoses included congenital myopathy, congenital idiopathic scoliosis, Padder Willi syndrome, cerebral palsy, “cri du chat” syndrome, and idiopathic early onset scoliosis. The average age of the patients at time of surgery was 8.3 years of age (5–14 years old). The average follow-up was 6 months. The average pre-operative Cobb angle was 71.33 degrees with average correction at last follow up equal to 29.66 degrees. No intra-operative complications were noted. One patient required one revision surgery consisting of adding TGV for fluctuating bursa over distal fixation due to excessive motion. ConclusionWe present early results of a new spinal gliding implant in six patients. The Trolley Gliding Vehicle showed good correction of spinal deformity with low short-term complications rate. Results cannot provide any long term conclusion. A prospective clinical study has been started in Europe and will be undertake in Canada once Health Canada approves the implant.