[Surgical treatment of early-onset scoliosis with the StarLock implant system].

OBJECTIVE

The problem of early-onset scoliosis is the progression of spine curvature. With the StarLock instrumentation a corrected spinal growth can be achieved. Distraction is necessary once or twice a year.

INDICATIONS

Idiopathic, congenital and neuromuscular scoliosis.

CONTRAINDICATIONS

Ostoeoporosis. Arthrogryposis. Kyphosis.

SURGICAL TECHNIQUE

The use of a C-arm (anterior-posterior and lateral view) has to be possible. Pedicle screws are placed at the proximal and distal end of the curvature. Through distraction of the rods which are screwed to each other via parallel connectors, correction of the scoliosis can be achieved.

POSTOPERATIVE MANAGEMENT

Mobilization should be started 1 day postoperatively using an individual corset for 6 months. Distraction has to be done once or twice a year.

RESULTS

From March 2003 to October 2005, 14 children with early- onset scoliosis were treated with the StarLock instrumentation. After the first operation, the Cobb angle improved from 65 degrees (42-80 degrees ) to 26.5 degrees (18-45 degrees ) in the thoracic spine and from 22 degrees (18-55 degrees ) to 15 degrees (10-32 degrees ) in the lumbar spine. Lenghtenings were done every 6.8 months (5-9 months). The follow-up time was 4.5 years (3-6 years).

COMPLICATIONS

three rods and two screws broke. Infections and neurologic deficits were not observed.