Dual Growing Rod Technique for the Treatment of Progressive Early-Onset Scoliosis

Abstract

The dual growing rod technique is safe and effective. It maintains correction obtained at initial surgery while allowing spinal growth to continue. It provides adequate stability, increases the duration of treatment period, and has an acceptable rate of complication compared with previous reports using the single rod technique.

Growing rod concepts: state of the art

“…Complications were reported also in the study performed by Akbarnia et al [10] and published in 2005. The authors revised the technique of subcutaneous rodding and used two rods instead of one and dedicated connectors for distraction procedures with routine lengthening without waiting for deformity to increase.…”

“…While 48 % of the patients had complications of any nature, only 17 % required unplanned surgery. The authors concluded that the dual growing rod technique was safe and effective, and had an acceptable rate of complications compared with previous reports while preserving near-normal growth [10]. Consistently better results have been reported with the use of double rods instead of a single one [11,12].…”

“…While this determination is an important milestone in the treatment of early-onset scoliosis, it also brings with it the question of whether growth is preserved or stimulated. Patients in Akbarnia et al's [10,12] series who were, for various reasons, lengthened more frequently than 6 months showed a greater amount of growth. Yilmaz et al [40] showed in their experimental study on 12 immature pigs that vertebral growth continues during growing rod treatment at an accelerated but statistically not significant rate.…”

“…This evolved to routine lengthening to catch up and keep pace with growth, with variable intervals of time due to reports detailing nearnormal growth with such practice [10,12]. It has also been observed that more frequent lengthenings result in a greater amount of growth achieved during the course of treatment [12].…”

Safety and compatibility of magnetic-controlled growing rods and magnetic resonance imaging

“…[2,3] Convex growth arrest, combined with posterior instrumentation, has been shown to slow progression but the most reliable non-fusion surgery in infantile idiopathic scoliosis is the implantation of growing rods. [4][5][6][7] These rods control spinal curvature and guide growth, permitting a delay to fusion and hence more favourable respiratory and cosmetic outcomes.…”