Abstract
PurposeWe aimed to evaluate the nutritional status of children with early onset scoliosis (EOS) and to determine if treatment with growing rod instrumentation improves weight percentile.MethodsData was retrospectively collected on 88 EOS patients treated with growing rods at six institutions. Mean age at surgery was 5.8 years, and mean Cobb angle was 75°. All patients were followed for at least 2 years (mean 4 years). Weights were converted to normative percentiles based on the patients’ age and gender.ResultsPreoperatively, 47 % (41/88) of patients were <5 percentile for weight, thus failing to thrive. There was a significant increase in mean postoperative weight percentiles at latest follow-up (p = 0.004). 49 % of patients gained weight, with a mean of 18 percentile. A significant relationship exists between age at initial surgery and percentile weight gain (p < 0.005), with children <4 years old not demonstrating postoperative improvement. This relationship was not confounded by preoperative weight, preoperative Cobb angle, or years of follow-up (p > 0.05). Children with neuromuscular and syndromic diagnoses do not appear to improve their mean nutritional status after surgery when compared to patients with idiopathic or congenital/structural scoliosis (p = 0.006).ConclusionFollowing growing rod treatment, there was significant improvement in nutritional status in approximately 50 % of patients, similar to that reported with VEPTR. Neuromuscular and syndromic patients did not experience nutritional improvement post-operatively. These findings support the theory that growing rods improve the clinical status of EOS patients, as nutritional improvement is one outcome of improved clinical status. The relationship between age at initial surgery and nutritional improvement is intriguing.
Highlights
Children with early-onset scoliosis (EOS) may have complex chest wall and/or spine deformities that compromise pulmonary function and contribute to thoracic insufficiency syndrome (TIS) [1]
Purpose We aimed to evaluate the nutritional status of children with early onset scoliosis (EOS) and to determine if treatment with growing rod instrumentation improves weight percentile
Following growing rod treatment, there was significant improvement in nutritional status in approximately 50 % of patients, similar to that reported with vertical expandable prosthetic titanium rib (VEPTR)
Summary
Children with early-onset scoliosis (EOS) may have complex chest wall and/or spine deformities that compromise pulmonary function and contribute to thoracic insufficiency syndrome (TIS) [1]. In these children, the energy expenditure dedicated to the increased work of breathing necessary for survival, in addition to underlying comorbidity, can approach the nutritional gain from eating. The use of VEPTR in children with EOS has been shown to improve their weight [4]. Another technique to improve spine deformity in children with EOS is spine-based growing rod surgery. While radiographic outcomes and complications are certainly important, there is a paucity of literature examining the clinical outcomes and benefits of growing rod intervention in children with EOS [8]
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