Skip to main content
Top
Published in: European Spine Journal 10/2016

01-10-2016 | Original Article

Incidence of proximal junctional kyphosis with magnetic expansion control rods in early onset scoliosis

Authors: P. Inaparthy, J. C. Queruz, D. Bhagawati, C. Thakar, T. Subramanian, C. Nnadi

Published in: European Spine Journal | Issue 10/2016

Login to get access

Abstract

Background

The introduction of magnetic expansion control growth rods for the surgical management of EOS has gained popularity. However, there are no published studies on the incidence of proximal junctional kyphosis (PJK) using this technique.

Purpose

The aim of this study is to report the incidence of PJK following treatment with magnetic growth rods in EOS.

Methods

Retrospective review of data from 21 cases (12 males, 9 females) over 3 years. PJK was obtained from whole spine X-rays pre-op, immediate post-op and last follow-up. Cobb angle was measured between the superior end plate of vertebra two levels above the upper instrumented vertebra (UIV) and the inferior end plate of the UIV. A difference of >10° between the pre-operative x-rays and the last follow-up X-rays was recorded as PJK.

Results

6/21 (28.6 %) had proximal junctional kyphosis of more than 10° at last follow-up. Average age was 5.3. Average follow-up was 32.5 months. All the patients with PJK were syndromic. Four out of these six patients were males (66 %). Average PJK angle was 25.55°. Average pre-operative kyphosis was 52.5°. Average number of distractions was 7.4. All six patients had syndromic association. 3/6 patients (50 %) were conversion cases treated with traditional growth rods previously (TGR). None of the patients required unplanned surgery for PJK.

Conclusion

The incidence of PJK in EOS patients treated with magnetic rods is favourably comparable to that reported with traditional growth rods. Also, children who are male, syndromic, hyperkyphotic, and younger must be monitored closely.
Literature
1.
go back to reference Pehrsson K, Larsson S, Oden A, Nachemson A (1992) Long-term follow-up of patients with untreated scoliosis. A study of mortality, causes of death, and symptoms. Spine (Phila Pa 1976) 17(9):1091–1096CrossRef Pehrsson K, Larsson S, Oden A, Nachemson A (1992) Long-term follow-up of patients with untreated scoliosis. A study of mortality, causes of death, and symptoms. Spine (Phila Pa 1976) 17(9):1091–1096CrossRef
2.
go back to reference Swank SM, Winter RB, Moe JH (1982) Scoliosis and cor pulmonale. Spine (Phila Pa 1976) 7(4):343–354CrossRef Swank SM, Winter RB, Moe JH (1982) Scoliosis and cor pulmonale. Spine (Phila Pa 1976) 7(4):343–354CrossRef
3.
go back to reference Campbell RM Jr, Smith MD (2007) Thoracic insufficiency syndrome and exotic scoliosis. J Bone Joint Surg Am 89(Suppl 1):108–122 (Review) CrossRefPubMed Campbell RM Jr, Smith MD (2007) Thoracic insufficiency syndrome and exotic scoliosis. J Bone Joint Surg Am 89(Suppl 1):108–122 (Review) CrossRefPubMed
4.
go back to reference Harrington PR (1962) Treatment of scoliosis. Correction and internal fixation by spine instrumentation. J Bone Joint Surg Am 44-A:591–610PubMed Harrington PR (1962) Treatment of scoliosis. Correction and internal fixation by spine instrumentation. J Bone Joint Surg Am 44-A:591–610PubMed
5.
go back to reference Akbarnia BA, Marks DS, Boachie-Adjei O, Thompson AG, Asher MA (2005) Dual growing rod technique for the treatment of progressive early-onset scoliosis: a multicenter study. Spine (Phila Pa 1976) 30(17 Suppl):S46–S57CrossRef Akbarnia BA, Marks DS, Boachie-Adjei O, Thompson AG, Asher MA (2005) Dual growing rod technique for the treatment of progressive early-onset scoliosis: a multicenter study. Spine (Phila Pa 1976) 30(17 Suppl):S46–S57CrossRef
6.
go back to reference Hickey BA, Towriss C, Baxter G, Yasso S, James S, Jones A, Howes J, Davies P, Ahuja S (2014) Early experience of MAGEC magnetic growing rods in the treatment of early onset scoliosis. Eur Spine J 23(Suppl 1):S61–S65CrossRefPubMed Hickey BA, Towriss C, Baxter G, Yasso S, James S, Jones A, Howes J, Davies P, Ahuja S (2014) Early experience of MAGEC magnetic growing rods in the treatment of early onset scoliosis. Eur Spine J 23(Suppl 1):S61–S65CrossRefPubMed
7.
go back to reference Dannawi Z, Altaf F, Harshavardhana NS, El Sebaie H, Noordeen H (2013) Early results of a remotely-operated magnetic growth rod in early-onset scoliosis. Bone Joint J 95(B(1)):75–80CrossRefPubMed Dannawi Z, Altaf F, Harshavardhana NS, El Sebaie H, Noordeen H (2013) Early results of a remotely-operated magnetic growth rod in early-onset scoliosis. Bone Joint J 95(B(1)):75–80CrossRefPubMed
8.
go back to reference Akbarnia BA, Breakwell LM, Marks DS, McCarthy RE, Thompson AG, Canale SK, Kostial PN, Tambe A, Asher MA, Growing Spine Study Group (2008) Dual growing rod technique followed for three to eleven years until final fusion: the effect of frequency of lengthening. Spine (Phila Pa 1976) 33(9):984–990CrossRef Akbarnia BA, Breakwell LM, Marks DS, McCarthy RE, Thompson AG, Canale SK, Kostial PN, Tambe A, Asher MA, Growing Spine Study Group (2008) Dual growing rod technique followed for three to eleven years until final fusion: the effect of frequency of lengthening. Spine (Phila Pa 1976) 33(9):984–990CrossRef
9.
go back to reference Bess S, Akbarnia BA, Thompson GH, Sponseller PD, Shah SA, El Sebaie H, Boachie-Adjei O, Karlin LI, Canale S, Poe-Kochert C, Skaggs DL (2010) Complications of growing-rod treatment for early-onset scoliosis: analysis of one hundred and forty patients. J Bone Joint Surg Am 92(15):2533–2543CrossRefPubMed Bess S, Akbarnia BA, Thompson GH, Sponseller PD, Shah SA, El Sebaie H, Boachie-Adjei O, Karlin LI, Canale S, Poe-Kochert C, Skaggs DL (2010) Complications of growing-rod treatment for early-onset scoliosis: analysis of one hundred and forty patients. J Bone Joint Surg Am 92(15):2533–2543CrossRefPubMed
10.
go back to reference Thompson GH, Akbarnia BA, Kostial P, Poe-Kochert C, Armstrong DG, Roh J, Lowe R, Asher MA, Marks DS (2005) Comparison of single and dual growing rod techniques followed through definitive surgery: a preliminary study. Spine (Phila Pa 1976) 30(18):2039–2044CrossRef Thompson GH, Akbarnia BA, Kostial P, Poe-Kochert C, Armstrong DG, Roh J, Lowe R, Asher MA, Marks DS (2005) Comparison of single and dual growing rod techniques followed through definitive surgery: a preliminary study. Spine (Phila Pa 1976) 30(18):2039–2044CrossRef
11.
go back to reference Shah SA, Karatas AF, Dhawale AA, Dede O, Mundis GM Jr, Holmes L Jr, Yorgova P, Neiss G, Johnston CE, Emans JB, Thompson GH, Pawelek JB, Akbarnia BA, Growing Spine Study Group (2014) The effect of serial growing rod lengthening on the sagittal profile and pelvic parameters in early-onset scoliosis. Spine (Phila Pa 1976) 39(22):E1311–E1317CrossRef Shah SA, Karatas AF, Dhawale AA, Dede O, Mundis GM Jr, Holmes L Jr, Yorgova P, Neiss G, Johnston CE, Emans JB, Thompson GH, Pawelek JB, Akbarnia BA, Growing Spine Study Group (2014) The effect of serial growing rod lengthening on the sagittal profile and pelvic parameters in early-onset scoliosis. Spine (Phila Pa 1976) 39(22):E1311–E1317CrossRef
12.
go back to reference Watanabe K, Uno K, Suzuki T, Kawakami N, Tsuji T, Yanagida H, Ito M, Hirano T, Yamazaki K, Minami S, Taneichi H, Imagama S, Takeshita K, Yamamoto T, Matsumoto M (2014) Risk Factors for Proximal Junctional Kyphosis Associated with Dual-Rod Growing-Rod Surgery for Early-Onset Scoliosis. J Spinal Disord Tech. doi:10.1097/BSD.0000000000000127 Watanabe K, Uno K, Suzuki T, Kawakami N, Tsuji T, Yanagida H, Ito M, Hirano T, Yamazaki K, Minami S, Taneichi H, Imagama S, Takeshita K, Yamamoto T, Matsumoto M (2014) Risk Factors for Proximal Junctional Kyphosis Associated with Dual-Rod Growing-Rod Surgery for Early-Onset Scoliosis. J Spinal Disord Tech. doi:10.​1097/​BSD.​0000000000000127​
13.
go back to reference Schroerlucke SR, Akbarnia BA, Pawelek JB, Salari P, Mundis GM Jr, Yazici M, Emans JB, Sponseller PD, Growing Spine Study Group (2012) How does thoracic kyphosis affect patient outcomes in growing rod surgery? Spine (Phila Pa 1976) 37(15):1303–1309CrossRef Schroerlucke SR, Akbarnia BA, Pawelek JB, Salari P, Mundis GM Jr, Yazici M, Emans JB, Sponseller PD, Growing Spine Study Group (2012) How does thoracic kyphosis affect patient outcomes in growing rod surgery? Spine (Phila Pa 1976) 37(15):1303–1309CrossRef
14.
go back to reference Kim YJ, Bridwell KH, Lenke LG, Kim J, Cho SK (2005) Proximal junctional kyphosis in adolescent idiopathic scoliosis following segmental posterior spinal instrumentation and fusion: minimum 5-year follow-up. Spine (Phila Pa 1976) 30(18):2045–2050CrossRef Kim YJ, Bridwell KH, Lenke LG, Kim J, Cho SK (2005) Proximal junctional kyphosis in adolescent idiopathic scoliosis following segmental posterior spinal instrumentation and fusion: minimum 5-year follow-up. Spine (Phila Pa 1976) 30(18):2045–2050CrossRef
15.
go back to reference Glattes RC, Bridwell KH, Lenke LG, Kim YJ, Rinella A, Edwards C II (2005) Proximal junctional kyphosis in adult spinal deformity following long instrumented posterior spinal fusion: incidence, outcomes, and risk factor analysis. Spine (Phila Pa 1976) 30(14):1643–1649CrossRef Glattes RC, Bridwell KH, Lenke LG, Kim YJ, Rinella A, Edwards C II (2005) Proximal junctional kyphosis in adult spinal deformity following long instrumented posterior spinal fusion: incidence, outcomes, and risk factor analysis. Spine (Phila Pa 1976) 30(14):1643–1649CrossRef
16.
go back to reference Cheung Jason Pui Yin, Cahill Patrick, Yaszay Burt, Akbarnia Behrooz A, Cheung Kenneth MC (2015) Special article: update on the magnetically controlled growing rod: tips and pitfalls. J Orthop Surg 23(3):383–390CrossRef Cheung Jason Pui Yin, Cahill Patrick, Yaszay Burt, Akbarnia Behrooz A, Cheung Kenneth MC (2015) Special article: update on the magnetically controlled growing rod: tips and pitfalls. J Orthop Surg 23(3):383–390CrossRef
17.
go back to reference Atici Y, Akman YE, Erdogan S, Sari S, Yavuz U, Carkci E, Kaygusuz MA (2015) The effect of growing rod lengthening technique on the sagittal spinal and the spinopelvic parameters. Eur Spine J 24:1148–1157CrossRefPubMed Atici Y, Akman YE, Erdogan S, Sari S, Yavuz U, Carkci E, Kaygusuz MA (2015) The effect of growing rod lengthening technique on the sagittal spinal and the spinopelvic parameters. Eur Spine J 24:1148–1157CrossRefPubMed
18.
go back to reference El-Hawary R, Sturm P, Cahill P, Samdani A, Vitale M, Gabos P, Bodin N, d’Amato C, Harris C, Al Khudairy A, Smith JT (2015) What is the risk of developing proximal junctional kyphosis during growth friendly treatments for early-onset scoliosis? J Pediatr Orthop. doi:10.1097/BPO.0000000000000599 El-Hawary R, Sturm P, Cahill P, Samdani A, Vitale M, Gabos P, Bodin N, d’Amato C, Harris C, Al Khudairy A, Smith JT (2015) What is the risk of developing proximal junctional kyphosis during growth friendly treatments for early-onset scoliosis? J Pediatr Orthop. doi:10.​1097/​BPO.​0000000000000599​
19.
go back to reference Hickey BA, Towriss C, Baxter G, Yasso S, James S, Jones A, Howes J, Davies P, Ahuja S (2014) Early experience of MAGEC magnetic growing rods in the treatment of early onset scoliosis. Eur Spine J 23(Suppl 1):S61–S65CrossRefPubMed Hickey BA, Towriss C, Baxter G, Yasso S, James S, Jones A, Howes J, Davies P, Ahuja S (2014) Early experience of MAGEC magnetic growing rods in the treatment of early onset scoliosis. Eur Spine J 23(Suppl 1):S61–S65CrossRefPubMed
20.
go back to reference Dimeglio A, Bonnel F, Canavese F (2010) Normal growth of the spine and thorax. The growing spine, Springer, Berlin, Heidelberg, pp 13–42 Dimeglio A, Bonnel F, Canavese F (2010) Normal growth of the spine and thorax. The growing spine, Springer, Berlin, Heidelberg, pp 13–42
Metadata
Title
Incidence of proximal junctional kyphosis with magnetic expansion control rods in early onset scoliosis
Authors
P. Inaparthy
J. C. Queruz
D. Bhagawati
C. Thakar
T. Subramanian
C. Nnadi
Publication date
01-10-2016
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 10/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-016-4693-z

Other articles of this Issue 10/2016

European Spine Journal 10/2016 Go to the issue