Abstract
Background Severe and progressive scoliosis is a complex threedimensional spinal deformity that commonly requires treatment to address curve progression during growth. Standard treatment options for progressive scoliosis are essentially limited to bracing or surgery. Brace treatment is noninvasive and preserves growth; however it is only modestly successful in preventing curve progression and has a negative psychological impact [1-3] that may decrease patient compliance. Instead, surgical treatment with an instrumented spinal arthrodesis usually results in good deformity correction but has several risks. Those risks are associated to the invasiveness of spinal arthrodesis, the instantaneous correction of spinal deformity, and the altered biomechanics of the fused spine. Spinal fusion can have deleterious effects on subsequent development. Besides the known loss of motion and risk of adjacent segment disease with long-segment fusion, the loss of growth potential can lead to a significant decrease in trunk height and may negatively impact pulmonary development. Therefore, recent interest has been focused on new strategies for the effective surgical management of severe scoliosis in young children without the use of multisegmental spinal fusion. Fusionless scoliosis surgery provides theoretical advantages over traditional surgical arthrodesis, including the potential preservation of growth, motion and function of the spine [4]. In this way, several methods have been developed to treat scoliosis in young patients that allow the natural growth and elongation of the developing spine.
Highlights
Severe and progressive scoliosis is a complex threedimensional spinal deformity that commonly requires treatment to address curve progression during growth
The purpose of this study was twofold; firstly, to create a structural experimental scoliosis in a rat model by tethering sutures between the left scapula and pelvis; and secondly, to correct the scoliosis and resulting vertebral structural deformities over time, using a shapememory alloy wire attached to the spine after the removal of the posterior tether
The number of rats was selected on the basis of a sample size and power analysis performed on the variance in spinal deformity creation and correction in five pilot animals
Summary
Brace treatment is noninvasive and preserves growth; it is only modestly successful in preventing curve progression and has a negative psychological impact [1,2,3] that may decrease patient compliance. Surgical treatment with an instrumented spinal arthrodesis usually results in good deformity correction but has several risks. Those risks are associated to the invasiveness of spinal arthrodesis, the instantaneous correction of spinal deformity, and the altered biomechanics of the fused spine. Besides the known loss of motion and risk of adjacent segment disease with long-segment fusion, the loss of growth potential can lead to a significant decrease in trunk height and may negatively impact pulmonary development. Fusionless scoliosis surgery provides theoretical advantages over traditional surgical arthrodesis, including the potential preservation of growth, motion and function of the spine [4]
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