title: Safety and efficacy of growing rod technique for pediatric congenital spinal deformities.
abstract: BACKGROUND
  Growing rod surgery is a modern alternative treatment for young children with early onset scoliosis. This is the first study focused on its use in progressive congenital spinal deformities.
  
  
  METHODS
  A retrospective study of 19 patients from the international multicenter Growing Spine Study Group with progressive congenital spinal deformities undergoing growing rod surgery who had a minimum of 2 years follow-up. We analyzed demographic and radiographic data including age at initial surgery, number of abnormal vertebrae per patient, number of lengthenings postoperatively, Cobb angle of the major curve preoperative, postoperative initial and at last follow-up, T1-S1 length, space available for the lung (SAL), length of follow up, and complications.
  
  
  RESULTS
  The mean age at surgery was 6.9 years (range: 3.2 to 10.7 y). The mean number of affected vertebrae per patient was 5.2 (range: 2 to 9 vertebrae). The mean number of lengthening was 4.2 (range: 1 to 10 lengthening) per patient. The major Cobb angle improved from 66 degrees (range: 40 to 95 degrees) preoperatively to 45 degrees (range: 13 to 79 degrees) initial postoperative and 47 degrees (range: 18 to 78 degrees) at the last follow-up. The mean T1-S1 length increased from 268.3 mm (range: 192 to 322 mm) postoperatively to a mean of 315.4 mm (range: 261 to 357 mm) at last follow-up. The mean T1-S1 length increase was 11.7 mm/y. The SAL ratio increased from 0.81 preoperatively to 0.94 at latest follow-up. The mean postoperative follow-up was 4 years (range: 2 to 6.6 y). Five patients (38%) had undergone final fusion and 14 are still under treatment. Complications have occurred in 8 patients (42%). There were 14 (14%) complications in 100 procedures: 11 implant related, 2 pulmonary, and 1 postoperative infection. There were no neurological complications.
  
  
  CONCLUSIONS
  Growing rods are a safe and effective treatment technique in selected patients with congenital spinal deformities. The deformity, spinal growth, and the SAL improved. The incidence of complication was relatively low.
  
  
  METHODS
  Level IV, case series.
authors.affiliation: Growing Spine Study Group, Hacettepe University Faculty of Medicine, Sihhiye, Ankara.
authors.forename: Hazeem B
authors.initials: HB
authors.lastname: Elsebai
authors.forename: Muharrem
authors.initials: M
authors.lastname: Yazici
authors.forename: George H
authors.initials: GH
authors.lastname: Thompson
authors.forename: John B
authors.initials: JB
authors.lastname: Emans
authors.forename: David L
authors.initials: DL
authors.lastname: Skaggs
authors.forename: Alvin H
authors.initials: AH
authors.lastname: Crawford
authors.forename: Lawrence I
authors.initials: LI
authors.lastname: Karlin
authors.forename: Richard E
authors.initials: RE
authors.lastname: McCarthy
authors.forename: Connie
authors.initials: C
authors.lastname: Poe-Kochert
authors.forename: Patricia
authors.initials: P
authors.lastname: Kostial
authors.forename: Behrooz A
authors.initials: BA
authors.lastname: Akbarnia
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012600:Scoliosis / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013131:Spine / Q000254:growth & development / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome