PMID- 25066626
OWN - NLM
STAT- MEDLINE
DCOM- 20151019
LR  - 20181202
IS  - 1878-1632 (Electronic)
IS  - 1529-9430 (Linking)
VI  - 15
IP  - 1
DP  - 2015 Jan 1
TI  - Spinal growth modulation with posterior unilateral elastic tether in immature 
      swine model.
PG  - 138-45
LID - S1529-9430(14)00693-7 [pii]
LID - 10.1016/j.spinee.2014.07.008 [doi]
AB  - BACKGROUND CONTEXT: Fusionless scoliosis surgery is frequently performed in 
      children. Many studies have analyzed the effects of spinal growth modulation by 
      tethering the anterior and anterolateral aspects of the spine in animal models. 
      However, few studies have reported the disc health and spinal motion in spines 
      with posterior unilateral elastic tethering. PURPOSE: To analyze the regional 
      radiography, biochemistry, and histology of spinal motion segments fixed by 
      posterior unilateral elastic tethering. STUDY DESIGN: A randomized controlled 
      trial. OUTCOME MEASURES: Preoperative and postoperative radiographs of the spines 
      were taken. After an 8-week recovery period, the spines were harvested en bloc 
      and underwent radiographic, biochemical, and histologic analyses. METHODS: 
      Fifteen 3-month-old swine were randomly divided into three groups. 
      Instrumentation was performed posteriorly in the swine. In the elastic fixation 
      (EF) group, five swine were instrumented on the left side of the lumbar vertebrae 
      from L1 to L5 with pedicle screws that were connected with a unilateral elastic 
      tether with tension to produce a curve on the spine. The same surgery was 
      performed in the five animals of the metal rod fixation (MF) group, in which the 
      screws were connected with metal rods and curves were established. In the control 
      group, five animals were instrumented with five screws with no connecting cable. 
      RESULTS: Scoliosis and lordosis were created in the coronal and sagittal planes 
      in both the EF and MF groups. On average, the Cobb angles were 12.16 degrees +/-1.37 degrees  and 
      9.10 degrees +/-2.02 degrees  (p=.023) in the coronal plane and 17.44 degrees +/-11.29 degrees  and 5.32 degrees +/-3.06 degrees  
      (p=.049) in the sagittal plane in the two groups, respectively. The vertebrae and 
      discs wedged on the tethered side in the two groups showed no significant 
      differences (p>.05). The thickness of end-plate epiphysis on the fixed side was 
      significantly decreased in the two groups (p=.032 and p=.024). No apparent change 
      was found in the gross morphology of the discs in the two groups. The 
      distribution of collagen types I and II decreased and that of matrix 
      metalloprotease-3 (MMP-3) increased in both the EF and MF groups. Additionally, 
      the proteoglycan synthesis decreased in the two groups. CONCLUSIONS: Unilateral 
      elastic tethering resulted in vertebral wedging and scoliosis. Although changes 
      in collagen and MMP-3 distribution, proteoglycan synthesis, end-plate epiphysis, 
      and disc thickness were observed, the tethered discs and end plates did not 
      demonstrate gross morphologic signs of degeneration.
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Liu, Jiaming
AU  - Liu J
AD  - Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese 
      Academy of Medical Science, Peking Union Medical College, Beijing 100730, China.
FAU - Li, Zheng
AU  - Li Z
AD  - Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese 
      Academy of Medical Science, Peking Union Medical College, Beijing 100730, China.
FAU - Shen, Jianxiong
AU  - Shen J
AD  - Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese 
      Academy of Medical Science, Peking Union Medical College, Beijing 100730, China. 
      Electronic address: shenjianxiong@medmail.com.cn.
FAU - Xue, Xuhong
AU  - Xue X
AD  - Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese 
      Academy of Medical Science, Peking Union Medical College, Beijing 100730, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140724
PL  - United States
TA  - Spine J
JT  - The spine journal : official journal of the North American Spine Society
JID - 101130732
SB  - IM
MH  - Animals
MH  - Lordosis/diagnostic imaging/surgery
MH  - Lumbar Vertebrae/diagnostic imaging/*surgery
MH  - Models, Animal
MH  - Orthopedic Procedures/*methods
MH  - Radiography
MH  - Scoliosis/diagnostic imaging/*surgery
MH  - Spinal Fusion/methods
MH  - Swine
MH  - Thoracic Vertebrae/diagnostic imaging/*surgery
OTO - NOTNLM
OT  - Animal model
OT  - Asymmetric tether
OT  - Elastic tether
OT  - Growth modulation
OT  - Scoliosis
OT  - Swine model
EDAT- 2014/07/30 06:00
MHDA- 2015/10/20 06:00
CRDT- 2014/07/29 06:00
PHST- 2013/09/03 00:00 [received]
PHST- 2014/06/13 00:00 [revised]
PHST- 2014/07/18 00:00 [accepted]
PHST- 2014/07/29 06:00 [entrez]
PHST- 2014/07/30 06:00 [pubmed]
PHST- 2015/10/20 06:00 [medline]
AID - S1529-9430(14)00693-7 [pii]
AID - 10.1016/j.spinee.2014.07.008 [doi]
PST - ppublish
SO  - Spine J. 2015 Jan 1;15(1):138-45. doi: 10.1016/j.spinee.2014.07.008. Epub 2014 
      Jul 24.