title: Vertebral body stapling in children younger than 10 years with idiopathic scoliosis with curve magnitude of 30° to 39°.
abstract: METHODS
  Dual-center, retrospective study.
  
  
  OBJECTIVE
  To evaluate whether vertebral body stapling (VBS) influences curve progression between 30° and 39° in children younger than 10 years with idiopathic scoliosis.
  
  
  BACKGROUND
  Patients younger than 10 years with idiopathic scoliosis of more than 30° have a 100% risk of progression to spine fusion regardless of nonoperative treatment. VBS may represent an alternative fusionless treatment option for this group of high-risk patients.
  
  
  METHODS
  Patients younger than 10 years with idiopathic thoracic or lumbar scoliosis of 30° to 39° who were treated with VBS with a minimum of 24 months of follow-up were studied. Outcome variables were curve progression and magnitude, surgical complications, and a need for reoperation. Preoperative and postoperative curve magnitudes were compared using a paired Student t test. Postoperative curve magnitudes were compared with one another using a paired Student t test. A P value of less than 0.05 was defined as statistically significant.
  
  
  RESULTS
  Twelve patients were studied (female: n = 12; average age: 7.8 yr [range: 6.3-9.7 yr]). Thirteen curves were treated with VBS (thoracic: n = 9; lumbar: n = 4). The average follow-up was 3.4 years (range: 2.2-5.4 yr). The average preoperative curve magnitude was 33.4° (range: 30°-39°). The immediate postoperative curve magnitude (19.0°; range: 0°-29°) and curve magnitude at the most recent follow-up (23.0°; range: 10°-34°) were significantly less than the preoperative magnitude of 33.4°. Both thoracic curves (100%) and lumbar curves (100%) were treated successfully. Curve magnitudes did not change significantly postoperatively between the first erect radiographs and the most recent follow-up. Two patients had pneumothorax, and 1 patient had symptomatic pleural effusion. No patient required definitive fusion for curve progression.
  
  
  CONCLUSIONS
  VBS is effective in controlling curve progression in the high-risk group of children younger than 10 years with idiopathic scoliosis between 30° and 39° in whom bracing may be ineffective.
authors: *Department of Orthopaedic Surgery, University of California at San Francisco, San Francisco, CA; and †Department of Orthopaedic Surgery, Shriners Hospitals for Children, Philadelphia, PA.
authors: Alexander A
authors: AA
authors: Theologis
authors: Patrick
authors: P
authors: Cahill
authors: Mike
authors: M
authors: Auriemma
authors: Randal
authors: R
authors: Betz
authors: Mohammad
authors: M
authors: Diab
mesh_terms: D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology* / Q000601:surgery*; D008297:Male; D012086:Reoperation; D012189:Retrospective Studies; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods; D013904:Thoracic Vertebrae / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome