Published in:
01-05-2011 | Symposium: Early Onset Scoliosis
Surgical Technique: Modern Luqué Trolley, a Self-growing Rod Technique
Published in: Clinical Orthopaedics and Related Research® | Issue 5/2011
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Background
The challenge when managing early-onset scoliosis (EOS) is to prevent curve progression while maintaining spinal growth. Current surgical treatments (growing rods, VEPTR) require repetitive interventions to lengthen the implants.
Questions/purposes
We asked whether a modern Luqué trolley construct could achieve and maintain scoliosis correction in EOS during spinal growth without the need for repetitive surgeries, thus decreasing the morbidity of the surgical treatment.
Methods
We retrospectively reviewed five patients who underwent a modern Luqué trolley construct between 2003 and 2008. This construct consists of inserting apical gliding spinal anchors using muscle-sparing techniques to the proximal and distal fixed anchors found in the dual growing rod construct. We documented age at surgery, correction and maintenance of deformity, spinal growth, number of procedures, and complications.
Results
The primary curve was corrected from 60° to 21° and was maintained at 21° at a minimum followup of 2 years (mean, 4 years; range, 2–5.5 years). An average of 10 vertebrae was spanned allowing the spine to grow a mean of 3 cm over 4 years, representing a mean of 77% of the expected growth. Two of the five cases outgrew the construct requiring lengthening of rods. One patient had gradual recurrence of deformity without substantial axial growth that required revision surgery after 4 years.
Conclusion
Modifications of the Luqué trolley may be useful for managing EOS without the morbidity of repetitive surgery. However, questions such as the effect of wear debris and the risk of spontaneous fusions still remain.
Level of Evidence
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.