Treatment of Severe Rigid Early-Onset Scoliosis with Co-Cr-Mo Guided Multidirectional Sliding Growth Rod Combined with Apical Control Techniques.

Abstract

To explore the efficacy and complications of the Co-Cr-Mo guided multidirectional sliding growth rod technique (CMSG) combined with apical control techniques (ACTs) in the treatment of severe rigid early-onset scoliosis (EOS). Twenty-two patients with severe rigid EOS were treated with the CMSG combined with ACTs. The surgical details and complications were recorded, and the Cobb angle, apical vertebra offset, and T1-S1 vertical height were measured. All patients were followed up for 24-144 (66.8±29.6) months. The coronal Cobb angle after the first surgery, the coronal apical vertebra offset after the first surgery, and the T1-S1 vertical height at the last follow-up were all improved compared with those before surgery (P < 0.05). The postoperative orthopedic effect was relatively satisfactory, and there was no aggravation of scoliosis. Complications occurred in 6 cases, including 1 case of rod fracture, 1 case of screw loosening, 2 cases of proximal junctional kyphosis, 1 case of trunk balance decompensation, and 1 case of local infection. The CMSG combined with ACTs can effectively correct scoliosis and control its progression in patients with severe rigid EOS, preserve the growth potential of the spine, and has a lower complication rate than traditional growth rod surgery.