Fusionless scoliosis surgery

Severe spinal deformity in young children is a formidable challenge for optimal treatment. Standard interventions for adolescents and adults, including spinal deformity correction and fusion, may not be appropriate for young patients with considerable growth remaining. Alternate surgical options that provide deformity correction and protect the growth remaining in the spine are needed to treat this population of patients best.

Several groups have reported very exciting advances in the field of deformity spine surgery. Updated findings concerning the successful implementation of growing rods have revived this technique as a viable option for preserving near normal growth of the spine. New techniques have also been recently described, including vertebral stapling that produces asymmetric and corrective growth of the concavity of a deformity, and vertical expandable prosthetic titanium rib instrumentation that indirectly corrects spine deformity and protects spine growth remaining to treat an associated thoracic insufficiency syndrome.

New techniques and instrumentation at the disposal of spine surgeons allow the treatment of this challenging patient population to approach the goals of deformity correction and maintenance with preservation of potential growth. Preliminary outcomes from the different techniques are promising, but further investigation, including long-term follow-up, is necessary.