Dataset Information

Temporary use of shape memory spinal rod in the treatment of scoliosis.

ABSTRACT: NiTinol shape memory alloy is characterized by its malleability at low temperatures and its ability to return to a preconfigured shape above its activation temperature. This process can be utilized to assist in scoliosis correction. The goal of this retrospective study was to evaluate the clinical and radiographic results of intraoperative use of shape memory alloy rod in the correction of scoliosis. From May 2002 to September 2006, 38 scoliosis patients (ranging from 50° to 120°; 22 cases over 70°) who underwent shape memory alloy-assisted correction in our institute were reviewed. During the operation, a shape memory alloy rod served as a temporary correction tool. Following correction, the rod was replaced by a rigid rod. The mean blood loss at surgery was 680 ± 584 ml; the mean operative time was 278 ± 62 min. The major Cobb angle improved from an average 78.4° preoperatively to 24.3° postoperatively (total percent correction 71.4%). In 16 patients with a major curve <70° and flexibility of 52.7%, the deformity improved from 58.4° preoperatively to 12.3° postoperatively (percent correction, 78.9%). In 22 patients with a major curve >70° and flexibility of 25.6%, the deformity improved from 94.1° preoperatively to 30.1° postoperatively (percent correction, 68.1%). Only one case had a deep infection. There were no neurologic, vascular or correction-related complications such as screw pullout or metal fracture. The study shows that the intraoperative use of a shape memory rod is a safe and effective method to correct scoliosis.

SUBMITTER: Wang Y

PROVIDER: S-EPMC3036020 | biostudies-literature | 2011 Jan

REPOSITORIES: biostudies-literature

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Temporary use of shape memory spinal rod in the treatment of scoliosis.

Wang Yan Y Zheng Guoquan G Zhang Xuesong X Zhang Yonggang Y Xiao Songhua S Wang Zheng Z

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 20100714 1

NiTinol shape memory alloy is characterized by its malleability at low temperatures and its ability to return to a preconfigured shape above its activation temperature. This process can be utilized to assist in scoliosis correction. The goal of this retrospective study was to evaluate the clinical and radiographic results of intraoperative use of shape memory alloy rod in the correction of scoliosis. From May 2002 to September 2006, 38 scoliosis patients (ranging from 50° to 120°; 22 cases over ...[more]

PMID: 20628769

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Project description:BackgroundObtaining and maintaining final shoulder balance after the entire treatment course is essential for early-onset scoliosis (EOS) patients. The relatively small number of growing-rod (GR) graduates who complete final fusion has resulted in an overall paucity of research on the GR treatment of EOS and a lack of research on the shoulder balance of EOS patients during GR treatment.MethodsTwenty-four consecutive patients who underwent GR treatment until final fusion were included. Radiographic shoulder balance parameters, including the radiographic shoulder height (RSH), clavicle angle (CA), and T1 tilt angle (T1T), before and after each step of the entire treatment were measured. Shoulder balance changes from GR implantation to the last follow-up after final fusion were depicted and analysed. Demographic data, surgical-related factors, and radiographic parameters were analysed to identify risk factors for final shoulder imbalance. The shoulder balance of patients at different time points was further analysed to explore the potential effect of the series of GR treatment steps on shoulder balance.ResultsThe RSH showed substantial improvement after GR implantation (P = 0.036), during the follow-up period after final fusion (P = 0.021) and throughout the entire treatment (P = 0.011). The trend of change in the CA was similar to that of the RSH, and the T1T improved immediately after GR implantation (P = 0.037). Further analysis indicated that patients with shoulder imbalance before final fusion showed significantly improved shoulder balance after fusion (P = 0.045), and their RSH values at early postfusion and the final follow-up did not show statistically significant differences from those in the prefusion shoulder balance group (P > 0.05). Early postfusion shoulder imbalance (odds ratio (OR): 19.500; 95% confidence interval (CI) = 1.777-213.949; P = 0.015) was identified as an independent risk factor for final shoulder imbalance.ConclusionsShoulder balance could be improved by GR implantation but often changes during the multistep lengthening process, and the final result is relatively unpredictable. Final fusion could further adjust the prefusion shoulder imbalance. Focusing on the prefusion shoulder balance of GR graduates and providing patients with early shoulder balance after fusion might be necessary.

Project description:The three-dimensional correction of severe rigid scoliosis has been improved by segmental pedicle screw instrumentation. However, there can be significant difficulty related to the use of a rigid rod, especially in the apex region of severe scoliosis. This study is a retrospective matched cohort study to evaluate the advantages of Nitinol shape memory alloy (SMA) rod-based correction by comparing the clinical and radiographic results obtained from using a temporary SMA rod and those from a standard rod in the correction of severe scoliosis. From May 2004 to September 2006, patients with matched curve type, ages at surgery, operative methods and fusion levels in our institute and instrumented with either SMA rods (n = 14) or traditional correction techniques (n = 16) were reviewed. In SMA group, the SMA rods served as a temporary intraoperative tool for deformity correction and were replaced by standard rods. The blood loss at surgery averaged 778 +/- 285 ml in the traditional group and 585 +/- 188 ml in the SMA group (P < 0.05). Operative time averaged 284 +/- 53 min in the SMA group and 324 +/- 41 min in the traditional group (P < 0.05). In the SMA group, the preoperative major curve was 92.6 degrees +/- 13.7 degrees with a flexibility of 25.5 +/- 7.3% was corrected to 29.4 degrees +/- 5.7 degrees demonstrating a 68.4% immediate postoperative correction. In the traditional group, the preoperative major curve was 88.6 degrees +/- 14.6 degrees with a flexibility of 29.3 +/- 6.6% was corrected to 37.2 degrees +/- 7.3 degrees demonstrating a 57.8% immediate postoperative correction. There was a statistic difference between the SMA group and traditional group in correction rate of the major thoracic curve. In the SMA group, one case suffered from deep infection 2 months postoperatively. In the traditional group, 6 of 16 cases suffered pedicle screw pull out or loosening during placement of the standard rod at the apex vertebrae on the concave side. In three cases, the mono-axial pedicle screws near the apex were abandoned and in five cases replaced with poly-axial pedicle screws. This study shows that the temporary use of SMA rod may reduce the operative time, blood loss, while improve the correction of the coronal plane when compared with standard techniques.

Dataset Information

Temporary use of shape memory spinal rod in the treatment of scoliosis.

Publications

Temporary use of shape memory spinal rod in the treatment of scoliosis.

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