Severe, Focal Early-Onset Congenital Scoliosis Treated with Hemivertebra/ 3-Column Osteotomies:
Outcomes of Growth Guidance vs. Growing Rods
These are 4 major goals when we surgically treat children with spinal deformity (not inclusive)
Traditional and Magnetically-Controlled Growing Rods are not ideal when dealing with severe, congenital scoliosis.
An alternative treatment is to use Spinal Growth Guidance (a.k.a. Shilla) to maintain correction and permit spinal growth.
As seen below, it is important to growth the thoracic and lumbar spine to allow optimal lung development. In this study, early fusion surgery creates a short thoracic spine, and chest, which negatively impacts lung development long-term.
The aim of this study was to compare Spinal Growth Guidance to Growing Rods (traditional, magnetic and the VEPTR) when we need to treat severe, congenital scoliosis.
This is the study cohort
The age at surgery, sex, and follow-up after surgery were similar between the Spinal Growth Guidance group and the Growing Rods group.
The Spinal Growth Guidance group had fewer lengthening procedures (in clinic and in the OR) and total number of suegical procedures.
Here is the data on the major coronal deformity
The T1-T12 distance was not different between the groups, however the T1-S1 distance (which is the entire thoracic and lumbar spine) demonstrated better growth.
Complications between the groups was similar
In conclusion, Spinal Growth Guidance:
- Better major deformity correction and maintenance of the correction
- Greater T1-S1 growth
- Fewer surgical procedures
Based on this study, Spinal Growth Guidance is the preferred method of surgical correcting severe congenital scoliosis when an apical resection is needed.