Self-growing Instrumentation With Gliding Connectors for Collapsing Spine Deformities in Children: A Novel Technique.

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.

LEVEL OF EVIDENCE: Level IV-case series.