Primary effect of dual growing rod technique for the treatment of severe scoliosis in young children.

BACKGROUND

Treatment of rapidly progressing scoliosis in young children is a challenge for spine surgeons. Some surgeons had begun to use dual growing rod technique for treatment of rapidly progressing scoliosis in young children and had achieved acceptable results. The aim of this study was to determine the primary results and complications of this new technique in China.

METHODS

Eleven children suffering from rapidly progressing scoliosis were treated with dual growing rod technique between November 2004 and March 2009 at Peking Union Medical College Hospital (PUMCH). There were 10 females and 1 male in the group with Risser sign of 0 grade. The mean age at initial surgery was 6.1 years (range, 2.1-10.9 years). Ten patients were diagnosed as congenital scoliosis and 1 patient neuromuscular scoliosis. All the patients had 1-4 lengthening procedures (mean, 1.8 procedures) after the initial surgeries. The radiographic results of all the patients were investigated.

RESULTS

The coronal Cobb angle of scoliosis improved from (67.64+/-11.43) degrees to (34.64+/-8.26) degrees after initial surgery with the correction rate observed at (47.15+/-16.48)%. The coronal trunk shift improved from (2.00+/-1.73) cm to (1.49+/-1.31) cm after initial surgery. The T1-S1 height increased from (25.47+/-6.16) cm to (28.84+/-5.69) cm after initial surgery. The coronal Cobb angle of scoliosis was (36.82+/-11.76) degrees and the coronal trunk shift was (1.11+/-1.29) cm after the most recent lengthening procedure with the most recent correction rate observed at (44.73+/-19.43)%. The T1-S1 height was (31.29+/-4.50) cm after the most recent lengthening procedure with an average T1-S1 length increase of 1.6 (range, 1.0-2.7) cm per year during the lengthening period. The sagittal balance was maintained. Five of the total patients (45.5%) had complications including: hook displacement, pedical screw loosening, and broken rod. We performed revision surgeries with simultaneous lengthening procedures in all 5 cases with satisfactory results.

CONCLUSIONS

The dual growing rod technique was useful in the management of rapidly progressing scoliosis in young children. This technique could control severe scoliosis, allow for spinal growth, and maintain the coronal and sagittal balance. But the technique has high complications requiring strict and regular follow-up.