title: 2014 Update on the 'growing spine surgery' for young children with scoliosis.
abstract: OBJECTIVE
  Spinal fusion procedures that are the mainstay of the treatment of progressive or severe curves in adolescents and adults are not suitable for most young children as there is a large magnitude of remaining growth. Early spinal fusion stunts the growth of the thorax and may interfere with the development of the lungs. Therefore, in children with early-onset scoliosis, 'growth friendly' instrumentation systems have been utilized to control the deformity while allowing the growth of the spine and the thoracic cage.
  
  
  RESULTS
  The experience with growing rods has been increasing, along with expanding indications. Several self-lengthening instrumentation systems have been introduced aiming for guided spinal growth. There has been considerable progress in the clinical and laboratory studies using magnetically controlled growing rod constructs. Growing rods and vertical expandable prosthetic titanium rib (VEPTR) systems provide deformity control while allowing for spinal growth along with a risk of spontaneous vertebral fusions. VEPTR may cause rib fusions as the implants overlie the thoracic cage and, therefore, the use in pure spinal deformities is controversial.
  
  
  CONCLUSIONS
  There have been exciting recent advances concerning the treatment of spinal deformities in young children. Despite these advances, the surgical treatment of early-onset scoliosis remains far from optimal and more development is on the way.
authors.affiliation: Hacettepe Universitesi Hastanesi, Ortopedi ve Travmatoloji Anabilim Dali, Sihhiye, Ankara, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Dede
authors.forename: Gokhan
authors.initials: G
authors.lastname: Demirkiran
authors.forename: Muharrem
authors.initials: M
authors.lastname: Yazici
mesh_terms: D002648:Child; D000075202:Contraindications; D006801:Humans; D060526:Magnetic Fields; D019736:Prostheses and Implants; D011474:Prosthesis Design; D011859:Radiography; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013123:Spinal Fusion; D013131:Spine / Q000000981:diagnostic imaging / Q000254:growth & development*; D017792:Surgical Stapling / Q000379:methods; D013905:Thoracoplasty / Q000379:methods; D014025:Titanium
chemical_list: D014025:Titanium