Results
In their first study (published in GSJ), the authors reported that “The wedged vertebra demonstrated an average increase of 17% (P =.00014) in the proportion of concave to convex heights ratio” and that “as expected, the control vertebra did not show any lateral deviance in the heights at the follow-ups.”
Agarwal and colleagues concluded that, “APC, instead of apical fusion in SHILLA, remodulates the apex vertebra, which may in turn help mitigate the loss of correction on long term due to crankshafting and adding on.” This may also translate into less invasive surgical procedure for children struggling with spinal deformities.
In their second study (published in SSRR), the researchers stated, “In conclusion, the results of this study suggest clinical equivalency with respect to correction, between the two clinical procedures, APC and traditional growth rod systems, at the current follow up period, however the latter presents an obvious disadvantage because it requires multiple surgeries to regularly distract the spine.” In this study they showed in countries with limited resources, where traditional growth rods are widely used, could instead benefit from APC. An equivalent method which requires fewer surgeries may translate into less pain, better recovery time and medical follow-up for such children and their families.
Looking Forward
Agarwal and colleagues will continue to conduct research and educate about this very interesting and novel approach. They are committed to improving surgical treatments for scoliosis and kyphoscoliosis.
Agarwal told OTW, “We would like for the deformity surgeons across the globe, who currently are using either conventional SHILLA technique and are experiencing crankshafting/adding-on/distal migration or traditional growth rods (repeated invasive surgery because patients can’t afford non-invasive magnetic growth rods), to try this technique (and publish their two, five, and ten years of follow-up results).”
Agarwal continued, “Essentially this technique is a hybrid of two key concepts: tethering/stapling (active in nature) and growth guidance (passive in nature).”
“Lately our team has been thinking about adding a third concept: distraction on the concave side (to improve the remodulation intensity), but we are still working on that concept with Professors Anand Agarwal, Arvind Jayaswal, and Vijay Goel. Perhaps we can incorporate another upcoming method called SDS (Spring Distraction System) into it, invented by Professors Rene Castelein and Moyo Kruyt. Traditional growth rods surgery is obsolete and more traumatic than other contemporary techniques, and it’s high time we let it go!”
