Researchers from the Pediatric Spine Study Group conducted an international multicenter investigation to evaluate the effect of preoperative body mass index on outcomes of magnetically controlled growing rod treatment in early-onset scoliosis. Published in the Journal of Pediatric Orthopaedics, curve correction and thoracic growth were comparable across weight groups despite differing complication risks, according to a recent study.
The researchers reviewed a prospectively collected international database, including 663 patients with early-onset scoliosis (EOS) treated with bilateral magnetically controlled growing rods (MCGRs) and followed for a minimum of 2 years. Patients were stratified into underweight (n=91), healthy weight (n=417), and overweight (n=155) groups according to Centers for Disease Control and Prevention growth charts. Radiographic outcomes, complications, and health-related quality of life, assessed using the Early Onset Scoliosis Questionnaire 24 (EOSQ-24), were analyzed. Patients with missing preoperative body mass index (BMI) data or follow-up shorter than 2 years were excluded.
Curve correction and thoracic growth outcomes were similar across BMI groups. The mean curve correction was 35% in underweight patients, 31% in healthy weight patients, and 31% in overweight patients. “BMI status did not influence curve correction, thoracic height increase, or EOSQ-24 outcomes in early-onset scoliosis patients,” noted the lead researcher Saarinen, Antti J. MD, PhD, of the Departments of Paediatric Orthopaedic Surgery, Orthopaedics and Traumatology, University of Turku and Turku University Hospital, Turku, Finland, and colleagues. Thoracic height gain at 2 years was 5.3 mm in underweight patients, 5.0 mm in healthy weight patients, and 3.9 mm in overweight patients. A linear mixed-effects model demonstrated that the difference between planned and achieved distraction values increased over time, but BMI status itself was not a predictor of distraction outcomes.
Complication rates, however, varied substantially. Overweight patients experienced higher overall complication rates compared with healthy weight and underweight patients. Implant breakage occurred more frequently in overweight patients, whereas it was less common in underweight and healthy weight groups. Wound-related complications, including dehiscence and superficial infections, were also more common in overweight patients. Healthy weight and underweight patients had lower overall complication rates compared with overweight patients.
Full disclosures can be found in the published study.
