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| early_onset_scoliosis [2025/07/04 20:55] – [Comparative cohort studies] administrador | early_onset_scoliosis [2025/07/04 20:57] (current) – administrador | ||
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| of print. PMID: 35661994.)). | of print. PMID: 35661994.)). | ||
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| - | ===== Comparative cohort studies ===== | ||
| - | In a [[registry]]-based [[comparative]] [[cohort study]] (EOS patients after [[implant]] [[removal]]) | ||
| - | Matan S Malka et al. | ||
| - | from the Morgan Stanley Children’s Hospital (Columbia Univ, New York). | ||
| - | Additional centers: Arkansas Children’s Hospital; Shriners Philadelphia; | ||
| - | published in [[Spine Deformity Journal]], | ||
| - | to evaluate if re-implanting growth-friendly constructs within 12 months after implant removal (ROI) stabilizes deformity compared to [[observation]]-only. | ||
| - | Early re-implantation (< | ||
| - | ((Malka MS, Lenke LG, Givens RR, Lu K, Rymond CC, McCarthy R, Samdani AF, Yaszay B, Pahys J, Vitale MG, Roye BD, Group PSS. [[Failure]] to replace removed [[growth friendly implant]]s results in deteriorating radiographic outcomes. Spine Deform. 2025 Jul 4. doi: 10.1007/ | ||
| - | |||
| - | |||
| - | ====== Critical Review ====== | ||
| - | |||
| - | - **Strengths**: | ||
| - | |||
| - | [[Multicenter]] registry with well-defined exposure groups. | ||
| - | |||
| - | Radiographic outcomes measured at a meaningful 2‑year follow-up. | ||
| - | |||
| - | Statistically robust with p-values: Cobb 81° vs 53° (p=0.003); progression ≥5°: 64% vs 30% (p=0.04) | ||
| - | |||
| - | - **Limitations**: | ||
| - | |||
| - | Small observation cohort (n=11) limits [[generalizability]]. | ||
| - | |||
| - | Indications for ROI and patient selection unclear—could [[bias]] results. | ||
| - | |||
| - | Lack of data on [[functional outcome]]s or complications post re-implantation. | ||
| - | |||
| - | Does not assess long-term outcomes past 2 years or final fusion timing. | ||
| - | |||
| - | ====== Score (0–10) ====== | ||
| - | |||
| - | 5.5 | ||
| - | |||
| - | (Moderate quality; clinically relevant, but underpowered and limited in scope) | ||
| - | |||
| - | ====== Takeaway for Practicing Neurosurgeons ====== | ||
| - | |||
| - | Prompt re-implantation after growth‑friendly device removal appears crucial to arrest deteriorating curves in EOS. However, decision-making should be individualized, | ||
| - | |||
| - | ====== Bottom Line ====== | ||
| - | |||
| - | Re-inserting a growth-friendly implant within 12 months of removal significantly reduces coronal curve progression over 2 years and should be prioritized when feasible—though data are limited by small control group and absence of long-term outcomes. | ||
| - | |||
| - | ==== Full Citation and Corresponding Author ==== | ||
| - | |||
| - | **Published online:** July 4, | ||
| - | **Corresponding author:** [[msm2244@cumc.columbia.edu]]. | ||
| ===== Literature ===== | ===== Literature ===== | ||