title: Longitudinal Pilot Analysis of Radiation Exposure During the Course of Growing Rod Treatment for Early-Onset Scoliosis.
abstract: Retrospective consecutive case series.
  
  
  
  To estimate the amount of ionizing radiation (IR) exposure in growing rod (GR) surgery for early-onset scoliosis.
  
  
  
  There is substantial evidence of the health hazards attributed to IR exposure. However, no studies have estimated the amount of IR exposure in GR surgery.
  
  
  
  A consecutive single-center series of GR patients were retrospectively reviewed. Of 28 total patients, 24 had a minimum 2-year follow-up and complete records available for analysis. All spine-related IR imaging studies excluding intraoperative fluoroscopy were tabulated and IR estimated based on historical controls in millisieverts (mSv).
  
  
  
  Initial x-ray evaluation for scoliosis was performed at a mean age of 4.0 years (range = birth to 9.7). Mean radiographic period was 8.5 years (range = 2.2 to 19.4). There was a statistically significant inverse correlation between patient age at time of initial IR and total mean IR (p < .05). Total IR was 3.4 times greater than that of estimated background radiation (2.4 mSv per year). Mean IR before index surgery and during the first postoperative year were 22.41 mSv and 10.78 mSv, respectively. Annual IR after the first postoperative year averaged 7.02 mSv (range = 2.25 to 13.45). Patients who underwent at least one revision surgery experienced significantly higher IR than nonrevision patients (79.95 vs. 46.58 mSv; p < .05). Overall, 89% of total IR was attributed to x-rays and 11% from computed tomography.
  
  
  
  Compared to the general public, GR patients had 3.4 times more IR than the estimated background radiation for the same duration of time. Younger patients and those requiring revision surgery had significantly higher IR doses. This study underscores the importance of recognizing the amount of IR used in the management of GR patients and its potential long-term risks.
  
  
  
  III.
authors.affiliation: San Diego Center for Spinal Disorders, 4130 La Jolla Village Dr # 300, San Diego, CA 92037, USA. Electronic address: gmundis1@gmail.com.
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Mundis
authors.affiliation: San Diego Center for Spinal Disorders, 4130 La Jolla Village Dr # 300, San Diego, CA 92037, USA.
authors.forename: Jeff B
authors.initials: JB
authors.lastname: Pawelek
authors.affiliation: San Diego Center for Spinal Disorders, 4130 La Jolla Village Dr # 300, San Diego, CA 92037, USA.
authors.forename: Edward K
authors.initials: EK
authors.lastname: Nomoto
authors.affiliation: San Diego Center for Spinal Disorders, 4130 La Jolla Village Dr # 300, San Diego, CA 92037, USA.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Hennessy
authors.affiliation: Rady Children's Hospital San Diego, 3020 Children's Way, San Diego, CA 92123, USA.
authors.forename: Burt
authors.initials: B
authors.lastname: Yaszay
authors.affiliation: San Diego Center for Spinal Disorders, 4130 La Jolla Village Dr # 300, San Diego, CA 92037, USA.
authors.forename: Behrooz A
authors.initials: BA
authors.lastname: Akbarnia
mesh_terms: D006801:Humans; D000069079:Radiation Exposure; D012189:Retrospective Studies; D012600:Scoliosis / Q000628:therapy*; D013131:Spine
keywords: Early-onset scoliosis; Growing rod technique; Ionizing radiation exposure; Radiographic imaging