GROWING RODS AS A TREATMENT MODALITY OF EARLY ONSET IDIOPATHIC SCOLIOSIS

Abstract

Technically, single growing rod instrumentation could be placed on the concave side of the spine to expand the smaller hemithorax.(59) Better radiographic correction and fewer complications with bilateral constructs. Thompson et al. also found that dual rods resulted in fewer complications and provided better correction due to the increased rigidity in the system when compared to single rods. (60) The force required distracting the spine doubles by the fifth lengthening procedure with less than 8 mm of spinal growth achieved with each lengthening after this point. Distraction forces were 40% higher in patients with apical fusions in addition to growing rods. (61) Children who undergo implantation at 3 or 4 years of age may therefore reach the limits of growing rod surgery within 2.5– 3.5 years and prior to sufficient thoracic and pulmonary development. The authors tend to favor the use of growing rods in older juvenile children (5–8 years of age) with curves greater than 60° where the primary deformity is spinal with limited pulmonary compromise. (62) Results - 53 - That complications were decreased by 13% with each year that surgery was delayed (63). Proximal and distal fusion blocks, including a minimum of four points of fixation, are recommended in all children (64). “Law of diminishing returns” was demonestrated that crescendos after seven lengthenings due to autofusion and spinal noncompliance. (57) This non-invasive outpatient procedure(MCGR) is effective and safe. Whether MCGR leads to significantly better outcomes than traditional growing rods is not yet known, but early results are positive and the avoidance of opendistractions is a great improvement. Additionally, this new growing rod system has potentially widespread applications in other disorders that could benefit from a non-invasive procedure to correct abnormalities. (58)