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Liang Xu, Yong Qiu, Zhonghui Chen, Benlong Shi, Xi Chen, Song Li, Changzhi Du, Zezhang Zhu and Xu Sun

E arly-onset scoliosis (EOS) refers to a complex 3D and rapidly progressed deformity. 4 , 15 , 23 Through periodical distraction across the nonfused portion of the deformed spine, the traditional dual growing rod (DGR) technique has been widely used in the treatment of patients with EOS due to its effectiveness in controlling coronal and sagittal deformity while also permitting pulmonary system development. 9 , 13 , 16 However, because this growth-friendly technique simply combines upper and lower instrumentation with dual rods, its limitation of lacking

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Daniel J. Cognetti, Amer F. Samdani, Joshua M. Pahys, Mari L. Groves and Steven W. Hwang

T he management of severe scoliosis in young children is complicated by 2 problems with conflicting solutions: the need for deformity correction and the need for continued longitudinal growth. Normal development and function of thoracic and abdominal organs relies in part on proper development of the vertebral column; however, definitive spinal fusion to correct deformity halts longitudinal growth, while more conservative management methods that allow growth, like bracing, may not adequately address the deformity. 2 , 6 , 11 Growing rods and their many variants

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Andrew C. Vivas, Steven W. Hwang and Joshua M. Pahys

S keletally immature patients with progressive spinal deformity are commonly treated using “growth-guiding instrumentation.” 1 Options for growth guidance include traditional growing rods and the more recently introduced magnetically controlled growing rods (MCGRs). Both constructs allow for spinal deformity correction and continued growth of the spine and thorax in patients with severe, progressive, early-onset scoliosis. Patients with respiratory failure due to chronic hypoventilation syndrome, high cervical spinal cord injury (SCI), or progressive

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Rodrigo Navarro-Ramirez, Oded Rabau, Alisson Teles, Susan Ge, Abdulaziz Bin Shebreen, Neil Saran and Jean Ouellet

Transcript Today we will be presenting to you a surgical technique to implement a self-growing rod construct termed “modern Luqué trolley.” Case presentation consists of a neuromuscular deformity that has been progressing over time, essentially collapsing spine, gradual getting worse from the age of 3 to the age of 5; essentially has a collapsing spine. Patient deformity is relatively flexible on traction film. Typical setup; we place the patient in halo and femoral traction. Retractors are inserted just above the metaphyseal flare. K-wires are placed across the

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Loyola V. Gressot, Akash J. Patel, Steven W. Hwang, Daniel H. Fulkerson and Andrew Jea

treated with long, instrumented, segmental spinal fusions to the ilium between 2007 and 2013 at Texas Children's Hospital (Neuro-Spine Program) in Houston, Texas. Institutional review board approval was obtained to conduct the study. Inclusion criteria consisted of age younger than 21 years at surgery, with a minimum of 6 months follow-up. Two children underwent placement of iliac screws as part of a growing rod construct rather than a definitive fusion, and thus are reported as a subgroup and not included in the statistical analysis. The preoperative diagnosis was

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Sarah F. Eby, Tricia St. Hilaire, Michael Glotzbecker, John Smith, Klane K. White, A. Noelle Larson and the Children’s Spine Study Group

fusion surgery. For young children, fusion caused a very short thorax, resulting in thoracic insufficiency syndrome and severe pulmonary disease. Growing rods were developed to allow for ongoing thoracic growth with regular lengthening of the spine, either through surgical lengthening procedures every 6 months or using a magnetically controlled growing rod device in the clinic. The vertical expandable prosthetic titanium rib (VEPTR, DePuy Synthes) was designed to treat children with rib deformity. The semiconstrained device attaches to the ribs proximally and to the

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Zhonghui Chen, Song Li, Yong Qiu, Zezhang Zhu, Xi Chen, Liang Xu and Xu Sun

I n recent years, various types of spine growth–friendly instrumentation have been used with the goal of minimizing spinal deformities while maximizing spine and thoracic growth in children with early-onset scoliosis (EOS). Based on repeated distractive forces they exert on the spine, vertical expandable prosthetic titanium ribs (VEPTRs) and growing rod instrumentation (GRI) have been classified as distraction-based instrumentation by Skaggs et al. 20 As originally described by Campbell and Hell-Vocke, 5 VEPTR was applied to young children with thoracic

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Michel Lefranc, F. François Deroussen and Richard Gouron

Fusionless surgery coupled with growing rod techniques is increasingly advocated for the treatment of early-onset scoliosis in general and neuromuscular scoliosis in particular. Iliosacral screws have excellent biomechanical characteristics but are hard to place safely. Here, the authors report on robot-assisted iliosacral screw positioning as part of growing rod surgery for the fusionless correction of early-onset scoliosis. The technique is based on a bilateral double sliding rod construct anchored to the pelvis proximally with 6 hooks or sublaminar bands and distally with iliosacral screws placed by the robot.

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K. Aaron Shaw, Nicholas D. Fletcher, Dennis P. Devito and Joshua S. Murphy

reported to be as high as 84% during the course of treatment. 2 , 24 , 29 Part of the reason for this high complication rate is patient characteristics, with early-onset scoliosis having a high association with neuromuscular or syndromic conditions. 24 As such, postoperative admission following surgical lengthening has been common practice after exposure to a general anesthetic. With the recent introduction of magnetically controlled growing rods, the ability to perform outpatient implant lengthening has become common practice with the touted advantage over traditional