title: Do Growing Rods for Idiopathic Early Onset Scoliosis Improve Activity and Participation for Children?
abstract: To investigate whether growing rod surgery for children with progressive idiopathic early onset scoliosis (EOS) effects activity and participation, and investigate factors that may affect this.
  
  
  
  Multicenter retrospective cohort study using prospectively collected data on 60 children with idiopathic EOS and significant scoliosis (defined as a Cobb angle >40°). Thirty underwent brace treatment, and 30, growth rod surgery. Questionnaire and radiographic data were recorded at 1 year. The validated Activities Scale for Kids performance version (ASKp) questionnaire was used to measure activity and participation.
  
  
  
  In the brace group, Cobb angle increased from 60° to 68°. There was no change in ASKp score. In the operative group, Cobb angle decreased from 67° to 45°. ASKp decreased from 91 to 88 (P < .01). Presence of spinal pain correlated with greater reduction in activity and participation scores in both groups, as did occurrence of complications in the operative group (P < .05). Both treatments permitted growth of the immature spine.
  
  
  
  In children with significant idiopathic EOS (Cobb angle>40°), growth rod surgery was associated with a reduction in activity and participation and Cobb angle, whereas brace treatment was associated with an increase in Cobb angle and no change in activity and participation. Pain was the most important factor affecting activity and participation in both groups.
authors.affiliation: Department of Pediatric Spinal Deformity, The James Cook University Hospital, Middlesbrough, United Kingdom.
authors.forename: Mathew David
authors.initials: MD
authors.lastname: Sewell
authors.affiliation: Department of Pediatric Spinal Deformity, The James Cook University Hospital, Middlesbrough, United Kingdom. Electronic address: j.platinum@hotmail.com.
authors.forename: Johnson
authors.initials: J
authors.lastname: Platinum
authors.affiliation: The Lady Cilento Children's Hospital, Brisbane, Australia.
authors.forename: Geoffrey Noel
authors.initials: GN
authors.lastname: Askin
authors.affiliation: The Lady Cilento Children's Hospital, Brisbane, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Labrom
authors.affiliation: The Royal Devon and Exeter Hospital, Exeter, United Kingdom.
authors.forename: Mike
authors.initials: M
authors.lastname: Hutton
authors.affiliation: The Royal Devon and Exeter Hospital, Exeter, United Kingdom.
authors.forename: Daniel
authors.initials: D
authors.lastname: Chan
authors.affiliation: The Royal Devon and Exeter Hospital, Exeter, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Clarke
authors.affiliation: The Royal Devon and Exeter Hospital, Exeter, United Kingdom.
authors.forename: Oliver M
authors.initials: OM
authors.lastname: Stokes
authors.affiliation: The Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
authors.forename: Sean
authors.initials: S
authors.lastname: Molloy
authors.affiliation: The Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
authors.forename: Stewart
authors.initials: S
authors.lastname: Tucker
authors.affiliation: The Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
authors.forename: Jan
authors.initials: J
authors.lastname: Lehovsky
mesh_terms: D001915:Braces / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006128:Growth; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects*; D008297:Male; D015999:Multivariate Analysis; D010147:Pain Measurement / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D013902:Radiography, Thoracic / Q000379:methods; D012189:Retrospective Studies; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000534:rehabilitation* / Q000601:surgery*; D012720:Severity of Illness Index; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
keywords: activity; early onset; growing rod; growth rod; growth sparing technique; participation; scoliosis