"Growth friendly" spine surgery: management options for the young child with scoliosis

The natural history of early onset scoliosis is dismal and associated with poor pulmonary function and increased mortality. Although limited in situ fusion may be appropriate for certain types of congenital scoliosis deformities, spinal deformity that affects young children often requires a "growth friendly" surgical approach that allows for curve control while maintaining growth of the spine and thorax. Growth-friendly surgical management of early onset scoliosis can follow a distraction-based (ie, growth rods, vertical expandable prosthetic titanium rib [Synthes, West Chester, PA]), guided-growth (ie, Luque trolley technique, Shilla technique), or compression-based (ie, tethers, staples) strategy.