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Spine (Phila Pa 1976). 2004 Sep 15;29(18):1980-9.

Fusionless scoliosis correction using a shape memory alloy staple in the anterior thoracic spine of the immature goat.

Author information

1
Department of Orthopedics, University of Utah, School of Medicine, Salt Lake City, Utah 84132, USA. john.braun@hsc.utah.edu

Abstract

STUDY DESIGN:

Experimental scoliosis was created in goats and then treated using anterior thoracic stapling.

OBJECTIVE:

To correct, without fusion, a progressive idiopathic-type scoliotic deformity in an immature goat model using a shape memory alloy staple.

SUMMARY OF BACKGROUND DATA:

Fusionless scoliosis treatment techniques, using minimally invasive approaches to the anterior thoracic spine, provide theoretical advantages over currently available forms of treatment.

METHODS:

Experimental scoliosis was created in 40 goats using a posterior asymmetric tether with convex rib resection and concave rib tethering for a period of up to 15 weeks. Twenty-seven goats with progressive deformities were used for subsequent study and randomized into 4 treatment groups: group I, anterior thoracic stapling with removal of the posterior tether; group II, removal of the posterior tether only; group III, anterior thoracic stapling with persistent posterior tethering; and group IV, persistent posterior tethering with no treatment. The treatment period lasted an additional 6 to 14 weeks. Staple backout was graded radiographically. After killing the goats, histology and disc biochemistry analyses were conducted.

RESULTS:

The goats in group I corrected from an initial 57 degrees of curvature to 43 degrees over the duration of the treatment period. Group II goats, which served as a control for group I, corrected from 67 degrees to 60 degrees during the treatment period. Group III goats demonstrated a modest correction from 65 degrees to 63 degrees with the stapling procedure, whereas group IV goats (controls for group III) progressed from 55 degrees to 67 degrees with a persistent posterior tether during the treatment period. The difference between the correction in group III and progression in group IV was statistically significant (P = 0.002). Complications were limited to partial staple backout in 27% of 56 staples.

CONCLUSIONS:

The results of this study support the efficacy of an anterior thoracic staple in correcting moderately severe scoliosis and halting the progression of more malignant scoliosis without fusion in a goat model.

PMID:
15371698
[Indexed for MEDLINE]

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