One-way self-expanding rods for early onset neuromuscular scoliosis: a two-year follow-up of an international cohort.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declarations. Conflict of interest: Conflic of interest The device(s)/drug(s) is/are FDA-approved or approved by corresponding national agency for this indication. No funds were received in support of this work. Relevant financial activities outside the submitted work: A.M. Post: no conflict of interest/ relevant financial activities M. Gaume: no conflict of interest/ relevant financial activities B.J. van Royen: no conflict of interest/ relevant financial activities E.R.C. Janssen: no conflict of interest/ relevant financial activities K.M. Lundine: Institutional research support funding from Euros Spine and Globus Spine M.B. Johnson: Institutional research support funding from Euros Spine and Globus Spine P. Neagoe: no conflict of interest/ relevant financial activities M.C. Kruyt: Euros research grant of 25.000 euro in 2020 L. Boissiere: Consultant and research support from Clarian Spinevision and travel accommodation from Euros JP. Kaleeta Maalu: no conflict of interest/ relevant financial activities J.J.M. Renkens: no conflict of interest/ relevant financial activities M.C. Deml: no conflict of interest/ relevant financial activities A. Stadhouder; yearly institutional research support funding from Euros F. Solla: Funding for congresses and meetings from Medtronic and SMAIO S. Schaible: no conflict of interest/ relevant financial activities C.S. Tabeling: no conflict of interest/ relevant financial activities J. Mielenbrink: no conflict of interest/ relevant financial activities L. Miladi: intellectual property rights with Euros company. 11. Eur Spine J. 2023 Feb;32(2):617-624. doi: 10.1007/s00586-022-07487-2. Epub 2022 Dec 15. The impacts of waiting for surgical correction of Adolescent Idiopathic Scoliosis and its repercussions for publicly funded health systems: systematic review. Pontes MDS(1), Soeira TP(2), Sampaio ML(3), Pratali RR(4), Pompeu Y(5), Herrero CFPDS(2). Author information: (1)Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, 11 Floor - Vila Monte Alegre - CEP 14048-900, Ribeirão Preto, SP, Brazil. marianadpontes@gmail.com. (2)Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, 11 Floor - Vila Monte Alegre - CEP 14048-900, Ribeirão Preto, SP, Brazil. (3)University of Ribeirão Preto, Ribeirão Preto, SP, Brazil. (4)Hospital Do Servidor Público Estadual, São Paulo, SP, Brazil. (5)Hospital for Special Surgery, New York, NY, USA. PURPOSE: To investigate, through a systematic review, the impact of the waiting time for Adolescent Idiopathic Scoliosis (AIS) surgical correction from the point of view of deformity evolution, treatment cost, and quality of life. METHODS: PubMed, Embase, LILACS, SciELO, Scopus, Web of Science, LIVIVO, and Cochrane Library databases were searched by two researchers to select the articles. The eligibility criteria were: Patients diagnosed with AIS with indication for surgical correction and submitted to waiting lists until treatment. The risks of bias were evaluated using the Risk Of Bias In Non-randomized Studies-Interventions (ROBINS-I) tool, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used to classify the level of the evidence for each outcome. The summary of the available evidence is presented in a narrative synthesis. RESULTS: Six observational studies were included. In a Canadian study, the primary outcome was the need for additional spine surgery in patients who had to wait more than three months due to spine deformity progression. American researchers presented a sample of premenarcheal and skeletally immature patients with AIS showing increased Cobb angle and attributed this to a six-month waiting for the surgical treatment. Another study included 177 patients with AIS with a mean waiting time of 225.7 days. There was a worsening average of 7.7° ± 8.6° in Cobb angle, and there was a change in surgical plan in 28 patients, which increased surgical time. Studies that evaluated the treatment cost showed significantly higher mean costs in those who waited longer than six months. Regarding the quality of life, while waiting for surgery, a retrospective study found that patients who underwent surgery earlier showed better results in a questionnaire that assessed their quality of life compared to those who were still waiting. CONCLUSION: Observational studies show that, in individuals who are on waiting lists for AIS surgery, there is a worsening of the spinal deformity (substantial evidence), an increasing cost of treatment (moderate evidence) and it may negatively impact patients' quality of life (insufficient evidence). Performing better methodological quality studies to investigate these outcomes can violate good research practices since randomized clinical trials on this subject have ethical limitations to be carried out. TRIAL REGISTRATION: The authors declare that the systematic review protocol was registered at the international prospective register of systematic reviews (PROSPERO), CRD42020212134, and it was accepted for publication. © 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. DOI: 10.1007/s00586-022-07487-2