The efficacy and complications of dual growing rod technique for early onset scoliosis

English Keywords:Early onset scoliosis  Dual growing rod technique  Thoracic insufficiency syndrome  Fusionless technique

English Abstract:

  【Abstract】 Objectives: To evaluate the clinical outcomes of the dual growing rod technique for early onset scoliosis(EOS). Methods: 14 patients(4 males, 10 females) undergoing dual growing rod technique for severe rigid congenital scoliosis in our hospital from February 2006 to June 2012 were retrospectively studied. The average age was 3.5±1.2 years(range, 2-5 years). The mean follow-up was 54.6±22.4(range, 24-100) months. The patients′ charts were reviewed. The parameters included age at initial surgery and the final follow-up, number and frequency of lengthening, and complications. Radiographic evaluation included scoliosis Cobb angle, thoracic kyphosis, lumber lordosis, trunk shift, length of T1-S1 and instrumentation. Results: There was a total of 99 surgeries, 85(14 patients) of them were lengthening procedures. The average lengthening was of 6.1cm per patient. The mean scoliosis improved from 73.8°±19.1° to 35.8°±12.8° after initial surgery and was 34.5°±16.3° at the final follow-up. The average T1-S1 length was of 1.61cm per year. The SAL increased from 0.90±0.10 to 0.96±0.11 after initial surgery and was 0.96±0.11 at the final follow-up. Eight complications occurred in 4 patients and most of them were implant-related(7 complications), underwent revision surgery at the same time of lengthening procedures. No infection and complications of nervous system. Conclusions: For patients with progressive EOS and age of 5 years, dual growing rod technique can maintain correction achieved at initial surgery while allowing spinal growth. The deformity of thoracic cage can be improved while the growth potential of the thoracic cage is preserved. However, this technique requires multiple numbers of lengthening procedures and thus has higher risk of complications. These factors should be evaluated carefully before the surgery.