The Power of Springs to Treat Scoliosis

Abstract

Early Onset Scoliosis (EOS) is a deformity of the spine and trunk that is diagnosed before the age of 10 years. If left untreated, it may result in lifelong complaints of pain, pulmonary insufficiency and reduced quality of life. For years, researchers and clinicians have looked for the optimal surgical treatment which can correct the deformity while facilitating normal spinal- and thoracic growth. However, contemporary solutions have inherent disadvantages, such as a high complication rate and the need for frequent surgical- or outpatient lengthenings. At UMC Utrecht, a novel surgical implant for the treatment of EOS was created, the Spring Distraction System (SDS). It employs titanium springs to continuously correct the scoliotic curve, without requiring repeated lengthenings. This thesis investigates the biomechanical principles of SDS, and shows its clinical efficacy in several (multicenter) prospective study cohorts. The results are promising, with excellent correction of the curve while minimizing complications and the need for re-operations. We also investigated future applications of spring-powered correction of scoliosis. By combining torsional and longitudinal springs into a single implant, we have the opportunity to completely correct all dimensions of the scoliotic curvature. In this thesis, we show the efficacy of such a Double Spring Reduction (DSR) in several animal studies. Using the results of the SDS and DSR studies, it may become possible in the future to cure the scoliotic spine. This would be a revolution in scoliosis treatment.