Growth Rods for Early-Onset Scoliosis in Young Children

We feel privileged to be treating your patient, and I hope we have done justice to you, your practice and of course the patient. I think at the end of the day we all have one common goal — we want to see our patients happy. Otherwise you, me and Jivo would not be here on a Sunday evening, leaving our families aside, if we did not have this goal.

I always joke about this with my orthopedic fellows. I've had an orthopedic training program for the last 13 or 14 years, and not even one of them has opted for spine surgery as a career — they're very happy doing a knee replacement, arthroscopy, or a fracture nail instead. Spine surgery has evolved so much that the moment they look into the scope, everything is very tiny, and that can be discouraging — it looks very uphill. It takes a little while to enter the system and understand what's going on through keyholes; one has to be patient, because it has a steep learning curve and the margin of error is not there. So for the last four years I've run a dedicated fellowship national training program for spine fellows — once they're selected and come to me, they don't have the option to go to any other theatre, because they're now committed to spine surgery for the rest of their life.

They treat severe scoliosis in young children who are too small for spinal fusion, allowing the spine to lengthen and straighten gradually as the child grows, with final fusion delayed until the child reaches around 13 to 15 years of age.

Syndromic children with early-onset scoliosis can be chronologically 10 to 12 years old but appear physically much younger, sometimes like a four or five year old, making them too small for a definitive fusion procedure.

They use a technique called growth modulation, which corrects the spinal curve while still allowing the spine to lengthen naturally as the child grows, continuing until the child reaches roughly 13 to 15 years of age for final fusion.

Without growth rods, a young child would either need premature spinal fusion, which would stunt further growth, or be left to worsen without treatment.

One documented case involved a six-year-old syndromic child with a combined deformity of about 70 degrees of scoliosis and 70 degrees of kyphosis, too severe and too young for definitive fusion, illustrating the level of deformity growth rods are used to manage.