title: [Treatment of juvenile scoliosis: Increasing the lengthening interval with the growing rod technique should not necessarily compromise thoracic growth].
abstract: OBJECTIVE
  Serial lengthening with growing rods is recommended every six months for the treatment of early onset scoliosis. The objective of this study was to evaluate the longitudinal growth of the thorax and control of the deformity in a series of patients with juvenile scoliosis when time intervals were increased between lengthenings.
  
  
  METHODS
  Retrospective study of eight patients. The following variables were measured: the Cobb angle, the apical vertebral translation, the coronal balance, thoracic T1-L1 length, thoracic T5-T12 kyphosis, the proximal junctional kyphosis (PJK) angle, and the lumbar lordosis. Complications were recorded.
  
  
  RESULTS
  Five idiopathic and three syndromic scoliosis cases (mean age 9.4 ± 1.5 years) were evaluated. The initial surgery was followed by with an average of two distractions per patient. The mean time between distractions was 15.7 months. The final coronal main curve correction was 58%. Apical translation and coronal balance were improved and maintained after the surgeries. The thoracic (T1-L1) preoperative length was 20.8 cm, the postoperative length was 24.4 cm, and the final length was 26 cm. At the end of follow-up, the average growth of the thorax was 5.2 cm. The preoperative (T5-T12) kyphosis was 33.5°, and final 32.1°. The change in the PJK angle was 2.5° at the end of follow-up. Most complications were related to instrumentation. Two superficial wound infections were encountered.
  
  
  CONCLUSIONS
  For less severe juvenile scoliosis patients treated with growing rods, spacing out lengthenings over more than a year can decrease the number of surgeries, while still controlling the deformity and allowing longitudinal thoracic growth.
authors.affiliation: Unidad de Columna, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Getafe, Madrid, España. Electronic address: javierpizones@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Pizones
authors.affiliation: TR Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Marqués de Valdecilla, Santander, España.
authors.forename: T
authors.initials: T
authors.lastname: Rodríguez-López
authors.affiliation: Unidad de Columna, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Getafe, Madrid, España.
authors.forename: L
authors.initials: L
authors.lastname: Zúñiga
authors.affiliation: Unidad de Columna, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Getafe, Madrid, España.
authors.forename: F
authors.initials: F
authors.lastname: Sánchez-Mariscal
authors.affiliation: Unidad de Columna, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Getafe, Madrid, España.
authors.forename: P
authors.initials: P
authors.lastname: Álvarez-González
authors.affiliation: Unidad de Columna, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Getafe, Madrid, España.
authors.forename: E
authors.initials: E
authors.lastname: Izquierdo
mesh_terms: D001852:Bone Lengthening / Q000295:instrumentation* / Q000379:methods*; D001858:Bone Nails; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012600:Scoliosis / Q000601:surgery*; D013909:Thorax / Q000254:growth & development; D013997:Time Factors
keywords: Barras de crecimiento; Cirugía de escoliosis; Crecimiento longitudinal torácico; Escoliosis juvenil; Growing rods; Juvenile scoliosis; Longitudinal thoracic growth; Non-fusion techniques; Scoliosis surgery; Técnicas de no fusión