Three-dimensional correction of scoliosis by a double spring reduction system as a dynamic internal brace: a pre-clinical study in Göttingen minipigs

Autor: Justin V.C. Lemans, Sebastiaan P.J. Wijdicks, Gerrit Overweg, Edsko E.G. Hekman, Tom. P.C. Schlösser, René M. Castelein, Gijsbertus J. Verkerke, Moyo C. Kruyt
Přispěvatelé: Personalized Healthcare Technology (PHT), Extremities Pain and Disability (EXPAND), Biomedical Device Design and Production Technology, Biomechanical Engineering
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: The Spine Journal : official Journal of the North American Spine Society, 23(4), 599-608
Spine journal, 23(4), 599-608. Elsevier
ISSN: 1878-1632
1529-9430
Popis: BACKGROUND CONTEXT: Adolescent idiopathic scoliosis (AIS) is a major skeletal deformity that is characterized by a combination of apical rotation, lateral bending and apical lordosis. To provide full 3D correction, all these deformations should be addressed. We developed the Double Spring Reduction (DSR) system, a (growth-friendly) concept that continuously corrects the deformity through two different elements: A posterior convex Torsional Spring Implant (TSI) that provides a derotational torque at the apex, and a concave Spring Distraction System (SDS), which provides posterior, concave distraction to restore thoracic kyphosis. PURPOSE: To determine whether the DSR components are able to correct an induced idiopathic-like scoliosis and to compare correction realized by the TSI alone to correction enforced by the complete DSR implant. STUDY DESIGN/SETTING: Preclinical randomized animal cohort study. PATIENT SAMPLE: Twelve growing Göttingen minipigs. OUTCOME MEASURES: Coronal Cobb angle, T10-L3 lordosis/kyphosis, apical axial rotation, relative anterior lengthening. METHODS: All mini-pigs received the TSI with a contralateral tether to induce an idiopathic-like scoliosis with apical rotation (mean Cobb: 20.4°; mean axial apical rotation: 13.1°, mean lordosis: 4.9°). After induction, the animals were divided into two groups: One group (N=6) was corrected by TSI only (TSI only-group), another group (N=6) was corrected by a combination of TSI and SDS (DSR-group). 3D spinal morphology on CT was compared between groups over time. After 2 months of correction, animals were euthanized. RESULTS: Both intervention groups showed excellent apical derotation (TSI only-group: 15.0° to 5.4°; DSR-group: 11.2° to 3.5°). The TSI only-group showed coronal Cobb improvement from 22.5° to 6.0°, while the DSR-group overcorrected the 18.3° Cobb to -9.2°. Lordosis was converted to kyphosis in both groups (TSI only-group: -4.6° to 4.3°; DSR-group: -5.2° to 25.0°) which was significantly larger in the DSR-group (p
Databáze: OpenAIRE
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