Growth Preservation Surgery for Correction of Early Onset Scoliosis

Document Type : Original Article

Authors

Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: Early-onset scoliosis is a difficult challenge. The affected patients are young with significant remaining growth potential. Thus, patients will likely develop progressive deformities, cosmetic disfigurement and cardiopulmonary consequences and probably a neurologic deterioration. Conventional management tools, such as spinal bracing and casting, have not been shown to be effective or tolerable. In addition, fusion may also cause significant inhibition of normal spinal and thoracic growth and so thoracic insufficiency syndrome.
Aim of the work: To evaluate results of growth preservation surgery that control the deformity and allow continued growth of the spine and thoracic cavity by using growth friendly surgical techniques.
Patients and Methods: In this study, 20 patients with EOS were operated using 2 types of growing rods with a 6-month distraction protocol. Functional and growth outcomes were assessed.
Results: The average follow-up time was (24-28 months). The correction rate was 69.5% for Cobb angle and 49,.2% for kyphosis between preoperative and final follow-up period. The time between two lengthening was 6.9 months, and the mean T1-S1 length increase was 1.78 cm per year. The space available for the lung (SAL) ratio 0.71 increased from preinitially to 0.895 at the last follow-up. Acceptable improvements were determined in the specified parameters with low complication rates with the use of this technique.
Conclusion: The overall success for lengthening and maintence of lung and chest development were reasonable, we recommend using growing rods as a useful tool for management of patients with EOS. We advise using dual rod technique instead of single rod, Repetitive surgical interventions are the negative side of this technique.

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