The effect of distraction-based growth-friendly spinal instrumentation on growth in early-onset scoliosis

The present study assessed the advantages and disadvantages of growth-friendly spinal instrumentation surgery for early-onset scoliosis in 17 patients who underwent this surgery with a minimum 2-year follow-up. The mean number of lengthening procedures was three, initial age at which surgery was performed was 108.1 ± 30.2 months, and follow-up duration was 40.6 ± 16.6 months. Spinal height (T1-S1 and T1-T12), lung space available, major Cobb angle for scoliosis, maximum thoracic kyphosis, lumbar lordosis, shoulder and pelvic balance, and coronal and sagittal balance were assessed preoperatively and at the last follow-up. Treatment with growth-friendly spinal instrumentation showed evident increases in the spinal height and space available for the lungs, and significant improvement in scoliosis and thoracic kyphosis. The most commonly observed complications were proximal anchor problems and proximal junctional kyphosis. To avoid proximal junctional kyphosis in treatments with growing rods, excessive thoracic kyphosis correction should not be performed.