Institutional members access full text with Ovid®

Share this article on:

2014 Update on the ‘growing spine surgery’ for young children with scoliosis

Dede, Ozgur; Demirkiran, Gokhan; Yazici, Muharrem

doi: 10.1097/MOP.0000000000000036
ORTHOPEDICS: Edited by Daniel W. Green

Purpose of review 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.

Recent findings 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.

Summary 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.

Hacettepe Universitesi Hastanesi, Ortopedi ve Travmatoloji Anabilim Dali, Sihhiye, Ankara, Turkey

Correspondence to Muharrem Yazici, MD, Hacettepe Universitesi Hastanesi, Ortopedi ve Travmatoloji Anabilim Dali, Sihhiye, Ankara 06100, Turkey. Tel: +90 312 3051208; fax: +90 312 3100261; e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins