title: Self-growing Instrumentation With Gliding Connectors for Collapsing Spine Deformities in Children: A Novel Technique.
abstract: BACKGROUND
  The optimal management of young children with neuromuscular spinal deformities is currently unknown. A number of spinal instrumentation techniques have been proposed in early-onset scoliosis to achieve "guided growth," each with its drawbacks.
  
  
  OBJECTIVE
  To report a novel self-growing spinal instrumentation technique, designed to avoid recurrent surgeries in children with neuromuscular disease.
  
  
  METHODS
  The technique is based on the control of apical and end vertebrae by pedicle screw fixation and limited fusion. Standard 4.5 to 5.5 mm side-to-side rod connectors are used as gliding connections. Three children with neuromuscular disease underwent the described procedure. The patients were followed for an average of 36 months (range, 24 to 60 mo).
  
  
  RESULTS
  All patients who underwent the procedure showed an average spinal growth of 1.1 mm/year, which is comparable with normative growth data and previous reports using growing rods. One patient required the exchange of dislodged rods, secondary to the amount of growth of the spine. There were no other complications or unplanned surgeries during the follow-up period.
  
  
  CONCLUSIONS
  This novel method provided growth in a group of 3 patients with collapsing neuromuscular spine deformities.
  
  
  METHODS
  Level IV-case series.
authors: *Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA †Department of Orthopaedics and Traumatology, Hacettepe University School of Medicine, Ankara, Turkey.
authors: Ozgur
authors: O
authors: Dede
authors: Gokhan
authors: G
authors: Demirkiran
authors: Muharrem
authors: M
authors: Yazici
mesh_terms: D017668:Age of Onset; D002547:Cerebral Palsy / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D002648:Child; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008297:Male; D065289:Pedicle Screws; D011859:Radiography; D012600:Scoliosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods; D014897:Spinal Muscular Atrophies of Childhood / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D013131:Spine / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome