Evidence map›Paper›PMID 37450222›Full record

ArticleSpine deformity2023

Rib-to-spine and rib-to-pelvis magnetically controlled growing rods: does the law of diminishing returns still apply?

Jessica H Heyer, Jason B Anari, Keith D Baldwin, Stuart L Mitchell, John M Flynn, Wudbhav N Sankar, Lindsay M Andras, David L Skaggs, John T Smith, Scott J Luhmann and 7 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Spine deformity, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Jessica H HeyerDepartment of Pediatric Orthopaedics, Hospital for Special Surgery, New York, NY, USA.ORCID http://orcid.org/0000-0003-4895-6944
Jason B AnariDepartment of Orthopaedic Surgery, Children's Hospital of Philadelphia, 3500 Civic Center Blvd, Philadelphia, PA, 19104, USA.
Keith D BaldwinDepartment of Orthopaedic Surgery, Children's Hospital of Philadelphia, 3500 Civic Center Blvd, Philadelphia, PA, 19104, USA.
Stuart L MitchellDepartment of Orthopaedics, University of North Carolina, Chapel Hill, NC, USA.
John M FlynnDepartment of Orthopaedic Surgery, Children's Hospital of Philadelphia, 3500 Civic Center Blvd, Philadelphia, PA, 19104, USA.
Wudbhav N SankarDepartment of Orthopaedic Surgery, Children's Hospital of Philadelphia, 3500 Civic Center Blvd, Philadelphia, PA, 19104, USA.
Lindsay M AndrasDepartment of Orthopaedics, Children's Hospital of Los Angeles, Los Angeles, CA, USA.
David L SkaggsDepartment of Orthopaedics, Cedars Sinai, Los Angeles, CA, USA.
John T SmithDepartment of Orthopaedics, University of Utah Health, Salt Lake City, UT, USA.
Scott J LuhmannDepartment of Orthopaedic Surgery, Shriners Children's Pediatric Specialty Care, St. Louis, MO, USA.
Ishaan SwarupDepartment of Orthopaedics, UCSF Benioff Children's Hospitals, San Francisco, CA, USA.
Walter H TruongDepartment of Orthopaedics, Gilette Children's, St. Paul, MN, USA.
Jaysson T BrooksDepartment of Orthopaedics, Scottish Rite for Children, Dallas, TX, USA.
Ryan FitzgeraldChildren's Orthopaedic and Scoliosis Surgery Associates, St. Petersburg, FL, USA.
Ying LiDepartment of Orthopaedics, Univeristy of Michigan, Michigan Medicine, Ann Arbor, MI, USA.
Pediatric Spine Study Group
Patrick J CahillDepartment of Orthopaedic Surgery, Children's Hospital of Philadelphia, 3500 Civic Center Blvd, Philadelphia, PA, 19104, USA. CahillP1@chop.edu.ORCID http://orcid.org/0000-0002-7129-1007

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe Law Of Diminishing Returns (LODR) has been demonstrated for traditional growing rods, but there is conflicting data regarding the lengthening behavior of Magnetically Controlled Growing Rods (MCGR). This study examines a cohort of patients with early-onset scoliosis (EOS) with rib-to-spine or rib-to-pelvis-based MCGR implants to determine if they demonstrate the LODR, and if there are differences in lengthening behaviors between the groups.

methodsA prospectively collected multicenter EOS registry was queried for patients with MCGR with a minimum 2-year follow-up. Patients with rib-based proximal anchors and either spine- or pelvis-based distal anchors were included. Patients with non-MCGR, unilateral constructs, < 3 lengthenings, or missing > 25% datapoints were excluded. Patients were further divided into Primary-MCGR (pMCGR) and Secondary-MCGR (sMCGR).

results43 rib-to-spine and 31 rib-to-pelvis MCGR patients were included. There was no difference in pre-implantation, post-implantation and pre-definitive procedure T1-T12 height, T1-S1 height, and major Cobb angles between the groups (p > 0.05). Sub-analysis was performed on 41 pMCGR and 19 sMCGR rib-to-spine patients, and 31 pMCGR and 17 sMCGR rib-to-pelvis patients. There is a decrease in rod lengthenings achieved at subsequent lengthenings for each group: rib-to-spine pMCGR (rho = 0.979, p < 0.001), rib-to-spine sMCGR (rho = 0.855, p = 0.002), rib-to-pelvis pMCGR (rho = 0.568, p = 0.027), and rib-to-pelvis sMCGR (rho = 0.817, p = 0.007). Rib-to-spine pMCGR had diminished lengthening over time for idiopathic, neuromuscular, and syndromic patients (p < 0.05), with no differences between the groups (p > 0.05). Rib-to-pelvis pMCGR neuromuscular patients had decreased lengthening over time (p = 0.01), but syndromic patients had preserved lengthening over time (p = 0.65).

conclusionRib-to-spine and rib-to-pelvis pMCGR and sMCGR demonstrate diminished ability to lengthen over subsequent lengthenings.

Indexed as

PelvisRibsScoliosisSpineChildChild, PreschoolFemaleFollow-Up StudiesHumansMalePelvic BonesProspective StudiesRegistriesTreatment Outcomeearly onset scoliosisGrowing rodsMagnetic growing rodsRib-based anchors

Identifiers

PMID37450222

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.