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Fusionless Implants

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  • Fusionless Implants

    Med Biol Eng Comput. 2011 Jul 14. [Epub ahead of print]
    Biomechanical comparison of fusionless growth modulation corrective techniques in pediatric scoliosis.
    Driscoll M, Aubin CE, Moreau A, Parent S.
    Source

    École Polytechnique de Montréal, Mechanical Engineering Department, Montreal, Canada.
    Abstract

    Fusionless growth-sparing implants for the treatment of adolescent idiopathic scoliosis (AIS) attempt to manipulate vertebral growth to restore spinal alignment. This study critically explores different implants utilizing a human spine scoliotic finite element model (FEM). Stainless steel (SS) and shape memory alloy (SMA) staples and flexible tethers were modeled and alternatively integrated around the apex of the convexity of the scoliotic model. Stress profiles over vertebral growth plates were obtained. Two years of growth was simulated with non-instrumented and instrumented models, as curvature changes were quantified. Apical asymmetrical stresses in non-instrumented and instrumented scoliotic models with SS staple, flexible tether, and SMA staple were 0.48, 0.48, 0.23, and 0.33 MPa, respectively. Patient data and non-instrumented model progressed from 28° to 62° of thoracic Cobb angle over 2 years. Simulated projected long-term thoracic Cobb angles of instrumented models are 31° with SS staple, 31° with flexible tether, and 34° with SMA staple. Initial implant compression achieved during instrumentation provided a significant influence on initial and long-term spinal profiles. The developed FEM provides an effective platform with which to explore, critique, and enhance fusionless growth-sparing techniques.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
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    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  • #2
    fusionless surgical options

    Linda,

    Thanks for posting this abstract. As a mother of a child on the VBS waiting list it's encouraging to see the ongoing research on the topic of fusionless surgical options for JIS.
    Resilience

    treated w Milwaukee Brace FT for 3 yrs
    currently 46 with 35 LL and 40 RT curves

    8 yr old diagnosed w Scoli 8/10 with 27 LL and 27 RT
    11/10 TLSO Full Time
    4/11 22 LL and 24 RT on waiting list for VBS at Shriners Phila
    12/11 curves still in the 20s but now has some rib cage changes from the brace
    VBS 4/25/12 with Dr. Samdani. Pre Op: 29 RT and 25 LL Post Op: 17 RT and 9 LL
    10/13: 15 RT and 10 LL

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