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Bram Verhofste, MD, John Emans , MD, Patricia Miller, MS,

Is Growth-Friendly Surgery Effective for the Treatment of Spinal Deformity in Patients with Arthrogryposis Multiplex Congenita ?. Bram Verhofste, MD, John Emans , MD, Patricia Miller, MS, George Thompson, MD, Amer Samdani , MD, Francisco Sanchez Perez- Grueso , MD, Anna McClung, RN, BSN,

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Bram Verhofste, MD, John Emans , MD, Patricia Miller, MS,

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  1. Is Growth-Friendly Surgery Effective for the Treatment of Spinal Deformity in Patients with Arthrogryposis Multiplex Congenita? Bram Verhofste, MD, John Emans, MD, Patricia Miller, MS, George Thompson, MD, AmerSamdani, MD, Francisco Sanchez Perez-Grueso, MD, Anna McClung, RN, BSN, Pediatric Spine Study Group, Michael Glotzbecker, MD International Congress on Early Onset Scoliosis November 21-22, 2019 – Atlanta, GA

  2. Introduction Arthrogryposis Multiplex Congenita (AMC) 2+ congenital contractures >150-300 disorders Scoliosis: 30-70% Effect rigidity?

  3. Background AMC vs. AIS Less correction Increased complications, progression Reoperations 29% risk / 4Y Second highest (neurofibromatosis) Escobar syndrome Small subset AMC Outcomes: Escobar = IEOS

  4. Study Objectives 1) To evaluate the outcomes of growth-friendly surgery (GFI) in patients with AMC and spinal deformity 2) To compare these results to a matched cohort of idiopathic EOS (IEOS) patients to determine whether the presence of perceived spinal rigidity and extremity contractures influenced outcomes

  5. Methods: Study Design Retrospective cohort: 2 EOS databases Inclusion: Diagnosis AMC Early-onset scoliosis Growth-friendly surgery Exclusion: Neuromuscular etiology >10 years old at GFI <2Y follow-up Inadequate data

  6. Methods: Statistical Analysis Propensity Score Matching - Age - Sex - Curve magnitude - Construct type 35 AMC to 112 IEOS Linear mixed modeling Comparison of curve across groups

  7. Results Similar: age, constructs, GFI duration

  8. Results: Presentation 1 2 3 4

  9. Results: Growth-Friendly Surgery

  10. Results: Growth-Friendly Surgery

  11. Results: Adverse Events Median Complications 2 AMC vs. 1 IEOS (p=0.09) Median Revisions 2 AMC vs. 1 IEOS (p=0.88) Limitations Complication reporting Sagittal deformity / T1-S1 Intraoperative difficulty >> Currently analyzed

  12. Conclusion IEOS > AMC Initial correction IEOS = AMC Final curves Complications Revisions GFI is effective More aggressive management in AMC?

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