The primary effect of dual growing rod technique on the treatment of severe scoliosis in young children

Abstract

Objective To determine the primary effect of the dual growing rod technique on treat-ment of rapidly progressing scoliosis in young children. Methods Eleven children treated with dual growing rod technique because of rapidly progressing seoliosis between November 2004 and March 2009 were ana-lyzed. Instrumentation of Isola was used in 10 cases and TSRH Domino in 1. The mean age at initial surgery was 6.1 years. There were 10 females and 1 male in the group with Risser sign of 0 grade. Their diagnoses included 10 patients with congenital scoliosis and 1 with neuromuscular seolinsis. All the patients had 1-4 lengthening procedures. Results The coronal Cobb angle improved from 67.64°±11.43° to 34.640°±8.26° af-ter 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 was 36.82°±11.76° and the coronal trunk shift was (1.11±1.29) cm after the most recent lengthening procedure with the most recent correction rate ob-served at 44.73%±19.43%. The T1-S1 height was (31.29±4.50) cm after the most recent lengthening proce-dure with an average T1-S1 length increase of 1.6 cm per year during the lengthening period. Five of the total patients had complications including: hook displacement, pedical screw loosening, and broken rod. The coronal Cobb angle between pre-operative, initial surgery and the most recent lengthening procedure were significantly different. Conclusion The dual growing rod technique was useful in the management of rapidly progressing scoliosis in young children. This technique offers control of severe scoliosis, allows for spinal growth, and maintains the coronal and sagittal balance, but has high complications. Key words: Scoliosis; Child; Intenai fixators