Growing Rods Versus Shilla Growth Guidance: Better Cobb Angle Correction and T1-S1 Length Increase But More Surgeries

Area of Science:

• Spine surgery
• Pediatric orthopedics
• Scoliosis treatment

Background:

• Early-onset scoliosis (EOS) requires surgical intervention for spinal deformity correction.
• Limited comparative data exists for Shilla growth guidance versus traditional distraction-based growing rods (GR) in EOS treatment.

Purpose of the Study:

• To compare the efficacy and safety of Shilla growth guidance against distraction-based dual growing rods (GR) for treating early-onset scoliosis (EOS).

Main Methods:

• A multicenter, retrospective, case-matched comparison of 36 EOS patients treated with Shilla versus 36 treated with GR.
• Matching criteria included age at surgery, preoperative Cobb angle, and diagnosis.
• Follow-up duration was similar between groups (average 4.3–4.6 years).

Main Results:

• The GR group showed significantly greater Cobb angle improvement (36° vs. 23°) and T1-S1 length increase (8.8 cm vs. 6.4 cm) compared to the Shilla group.
• Shilla patients underwent fewer overall surgeries (2.8 vs. 7.4) but had a higher rate of unplanned procedures for implant complications.
• Overall complication rates were similar between the Shilla and GR groups (1.9 vs. 1.3).

Conclusions:

• Distraction-based growing rods (GR) offer superior spinal deformity correction and trunk length increase in EOS compared to Shilla growth guidance.
• While Shilla requires fewer planned surgeries, it is associated with a higher incidence of unplanned interventions due to implant complications.
• Both Shilla growth guidance and growing rods (GR) demonstrate comparable overall complication rates in the management of early-onset scoliosis (EOS).