Anterior vertebral stapling for the fusionless correction of scoliosis: Changes in motion stiffness following staple insertion and measurement of staple loading during movement

Shillington, Mark, Adam, Clayton J., Labrom, Robert D., & Askin, Geoffrey N. (2008) Anterior vertebral stapling for the fusionless correction of scoliosis: Changes in motion stiffness following staple insertion and measurement of staple loading during movement. In Haynes, David & Zreiqat, Hala (Eds.) Australian and New Zealand Orthopaedic Research Society (ANZORS) 14th Annual Scientific Meeting, 16-21 November, 2008, Brisbane, Australia. (Unpublished)

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To address the need for effective surgical options in patients who are too young for fusion procedures 'fusionless' growth modulation treatments have been developed. The goal of these techniques is to harness the patient’s inherent spinal growth and redirect it to achieve correction, rather than progression, of the deformity. Currently there are several surgical treatments incorporating the fusionless ideology, one of which is anterior vertebral stapling.
Recently clinical interest in stapling has increased following the release of a new staple designed specifically for insertion into the spine by Medtronic Sofamor Danek (Memphis., TN). These staples are manufactured using nitinol, a shape memory alloy (SMA) composed of nickel and titanium. Investigations using large animal models have shown these staples to be effective in modulating vertebral growth 1 and early results from a patient cohort have been promising. 2,3 Despite the increased clinical interest in the use of SMA staples little is known about the mechanism of their effect or the biomechanical consequences of their insertion on the immature spine. The aims of this study were threefold. Firstly, to measure changes in the bending stiffness of a single spinal motion segment following staple insertion. Secondly, to describe the staple forces that occur with spinal movement. Thirdly, to describe the vertebral structural changes that occur as a consequence of staple insertion. We propose however, that this effectiveness is not a consequence of unilateral compression of the vertebral physis, but rather that the insertion of an SMA staple causes vertebral hemiepiphysiodesis and subsequent convex growth arrest. Thoracic SMA stapling is a technique which has shown promising early clinical results. Based on our findings it is likely that, contrary to current beliefs, the clinical effect is due to vertebral hemiepiphysiodesis causing convex growth arrest.

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ID Code: 17334
Item Type: Conference Paper
Refereed: Yes
Keywords: thoracic spine stapling, shape memory alloy, fusionless scoliosis correction, idiopathic scoliosis, growing spine
Divisions: Past > QUT Faculties & Divisions > Faculty of Built Environment and Engineering
Current > Institutes > Institute of Health and Biomedical Innovation
Past > Schools > School of Engineering Systems
Copyright Owner: Copyright 2008 (The authors)
Deposited On: 03 Feb 2009 23:53
Last Modified: 10 Aug 2011 15:23

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