Vertebral Body Stapling in Children Younger Than 10 Years With Idiopathic Scoliosis With Curve Magnitude of 30° to 39°

Abstract

Dual-center, retrospective study. To evaluate whether vertebral body stapling (VBS) influences curve progression between 30° and 39° in children younger than 10 years with idiopathic scoliosis. Patients younger than 10 years with idiopathic scoliosis of more than 30° have a 100% risk of progression to spine fusion regardless of nonoperative treatment. VBS may represent an alternative fusionless treatment option for this group of high-risk patients. Patients younger than 10 years with idiopathic thoracic or lumbar scoliosis of 30° to 39° who were treated with VBS with a minimum of 24 months of follow-up were studied. Outcome variables were curve progression and magnitude, surgical complications, and a need for reoperation. Preoperative and postoperative curve magnitudes were compared using a paired Student t test. Postoperative curve magnitudes were compared with one another using a paired Student t test. A P value of less than 0.05 was defined as statistically significant. Twelve patients were studied (female: n = 12; average age: 7.8 yr [range: 6.3-9.7 yr]). Thirteen curves were treated with VBS (thoracic: n = 9; lumbar: n = 4). The average follow-up was 3.4 years (range: 2.2-5.4 yr). The average preoperative curve magnitude was 33.4° (range: 30°-39°). The immediate postoperative curve magnitude (19.0°; range: 0°-29°) and curve magnitude at the most recent follow-up (23.0°; range: 10°-34°) were significantly less than the preoperative magnitude of 33.4°. Both thoracic curves (100%) and lumbar curves (100%) were treated successfully. Curve magnitudes did not change significantly postoperatively between the first erect radiographs and the most recent follow-up. Two patients had pneumothorax, and 1 patient had symptomatic pleural effusion. No patient required definitive fusion for curve progression. VBS is effective in controlling curve progression in the high-risk group of children younger than 10 years with idiopathic scoliosis between 30° and 39° in whom bracing may be ineffective.