PMID- 32096132
OWN - NLM
STAT- MEDLINE
DCOM- 20201116
LR  - 20201116
IS  - 2212-1358 (Electronic)
IS  - 2212-134X (Linking)
VI  - 8
IP  - 3
DP  - 2020 Jun
TI  - Growth guidance constructs with apical fusion and sliding pedicle screws (SHILLA) 
      results in approximately 1/3rd of normal T1-S1 growth.
PG  - 531-535
LID - 10.1007/s43390-020-00076-7 [doi]
AB  - STUDY DESIGN: Retrospective, multicenter. OBJECTIVE: To investigate clinical 
      outcomes in particular T1-S1 growth in patients with SHILLA instrumentation 
      independent of inventor's reports. Guided growth with apical fusion and sliding 
      pedicle screws (GGC/SHILLA) is an alternative to distraction-based growing rods 
      for the treatment of EOS. A recent report of patients treated with GGC primarily 
      at the center where the procedure was invented reported surprisingly good spinal 
      growth similar to normal growth. METHODS: Retrospective review of EOS patients 
      treated with GGC between 2007 and 2013 was performed from a multicenter database 
      prior to final fusion. Inclusion criteria were < 10 years at index surgery and 
      minimum 2-year follow-up. Patients with GGC performed at the inventor's 
      institution or prior spinal instrumentation were excluded. Predicted normal T1-S1 
      change during the growth period was calculated for each patient based on 
      Dimeglio's growth rates. RESULTS: 20 patients (mean age at surgery: 5.7 years) 
      with the following diagnoses met inclusion criteria: syndromic (N = 9), 
      neuromuscular (N = 5), idiopathic (N = 3) and congenital (N = 3). Preoperative 
      mean Cobb was 77 degrees  (range 33 degrees -111 degrees ). Mean increase in T1-S1 length from 
      preoperative to postoperative was 51.5 mm, and change from postoperative to final 
      follow-up was 21.8 mm (4.2 mm/year) which was 36% of predicted growth. 15/20 
      (75%) patients underwent 21 revision surgeries most commonly for implant 
      complications (N = 26) and 8/20 (40%) underwent definitive fusion at a mean of 
      5.1 +/- 1.2 years after guided growth surgery. CONCLUSION: This study constitutes 
      the largest case series of patients with EOS treated with GGC outside of the 
      inventor's institution. The change in T1-S1 observed through the follow-up period 
      in EOS patients treated with GGC was approximately 1/3rd of predicted normal 
      growth, and less than 1/3rd of growth reported in previous reports. Similar curve 
      correction and complication rates but less T1-S1 growth during the growth period 
      were found compared to prior GGC (SHILLA) series.
FAU - Nazareth, Alexander
AU  - Nazareth A
AD  - Keck School of Medicine, University of Southern California, Los Angeles, USA.
AD  - Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset 
      Blvd., M/S 69, Los Angeles, CA, 90027, USA.
FAU - Skaggs, David L
AU  - Skaggs DL
AD  - Keck School of Medicine, University of Southern California, Los Angeles, USA. 
      dskaggs@chla.usc.edu.
AD  - Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset 
      Blvd., M/S 69, Los Angeles, CA, 90027, USA. dskaggs@chla.usc.edu.
FAU - Illingworth, Kenneth D
AU  - Illingworth KD
AD  - Keck School of Medicine, University of Southern California, Los Angeles, USA.
AD  - Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset 
      Blvd., M/S 69, Los Angeles, CA, 90027, USA.
FAU - Parent, Stefan
AU  - Parent S
AD  - Department of Surgery, Universite de Montreal, Montreal, USA.
FAU - Shah, Suken A
AU  - Shah SA
AD  - Department of Orthopaedics, Nemours/Alfred I, DuPont Hospital for Children, 
      Wilmington, USA.
FAU - Sanders, James O
AU  - Sanders JO
AD  - Department of Orthopaedics, University of North Carolina Orthopaedics, Chapel 
      Hill, USA.
FAU - Andras, Lindsay M
AU  - Andras LM
AD  - Keck School of Medicine, University of Southern California, Los Angeles, USA.
AD  - Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset 
      Blvd., M/S 69, Los Angeles, CA, 90027, USA.
CN  - Growing Spine Study Group
LA  - eng
PT  - Journal Article
DEP - 20200224
PL  - England
TA  - Spine Deform
JT  - Spine deformity
JID - 101603979
SB  - IM
MH  - Age Factors
MH  - Age of Onset
MH  - Child
MH  - Child, Preschool
MH  - Disease Progression
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Multicenter Studies as Topic
MH  - *Pedicle Screws
MH  - Retrospective Studies
MH  - Scoliosis/*physiopathology/*surgery
MH  - Severity of Illness Index
MH  - Spinal Fusion/*instrumentation/methods
MH  - Thoracic Vertebrae/*growth & development/*surgery
OTO - NOTNLM
OT  - Early-Onset Scoliosis
OT  - Guided growth with apical fusion
OT  - SHILLA
OT  - Sliding pedicle screws
OT  - Spinal growth
EDAT- 2020/02/26 06:00
MHDA- 2020/11/18 06:00
CRDT- 2020/02/26 06:00
PHST- 2019/04/24 00:00 [received]
PHST- 2019/12/21 00:00 [accepted]
PHST- 2020/02/26 06:00 [pubmed]
PHST- 2020/11/18 06:00 [medline]
PHST- 2020/02/26 06:00 [entrez]
AID - 10.1007/s43390-020-00076-7 [pii]
AID - 10.1007/s43390-020-00076-7 [doi]
PST - ppublish
SO  - Spine Deform. 2020 Jun;8(3):531-535. doi: 10.1007/s43390-020-00076-7. Epub 2020 
      Feb 24.