Radiographic Outcomes After Growing Rod Treatment in Early-Onset Scoliosis: With Versus Without Final Fusion Surgery

Area of Science:

• Orthopedic Surgery
• Pediatric Spine Deformities
• Spinal Growth Modulation

Background:

• Early-onset scoliosis (EOS) treatment with growing rods aims for spinal growth but may impact sagittal alignment.
• The necessity of final fusion surgery after growing rod treatment for EOS remains debated.

Purpose of the Study:

• To compare radiographic outcomes between EOS patients treated with growing rods who underwent final fusion versus those who did not.
• To evaluate the value of final fusion in achieving optimal coronal and sagittal spinal alignment.

Main Methods:

• Retrospective review of 19 EOS patients treated with growing rods (2015-2019).
• Classification into a final fusion group (n=9) and a graduated group (n=10) based on subsequent fusion status.
• Comparison of demographic, surgical, and radiographic parameters including Cobb angle, correction rate, and sagittal vertical axis.

Main Results:

• The final fusion group demonstrated significantly better Cobb angle correction (24.2° vs. 34.9°), correction rate (66.6% vs. 40.1%), and coronal balance (-1.5 mm vs. 19.7 mm).
• No significant differences in sagittal alignment were found, though thoracic kyphosis preservation trended favorably in the fusion group.

Conclusions:

• Final fusion surgery after growing rod treatment yields superior coronal correction and balance in EOS patients.
• While sagittal alignment differences were not statistically significant, final fusion may aid in preserving thoracic kyphosis. Consider fusion for significant residual curves or coronal imbalance.