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Growing systems and lengthening in scoliosis

What is scoliosis and what can be done?

Scoliosis is a lateral (sideways) curvature of the spine. The spinal column curves and twists causing problems which can extend to the ribs and pelvis. Often this happens in teenagers but can happen in children of any age. Smaller curves require no treatment with larger curves possibly requiring brace treatment or surgery. The surgery is usually a single operation to put instrumentation (metalwork or rods) in to correct the curve.

Who would need a growing system?

If the patient needs surgery but is of an age where they have lots of growth left, then a growth system may be offered. By doing this the spine can be corrected and encouraged to grow in a straighter position

What types of growing systems are available and how are they lengthened?

There are a few different systems and your spinal consultant will discuss which option is recommended in each individual case.

  1. There is a system which has overlapping rods which are then attached to the spine. As the child grows the rods pull away from each other but keep the spine in an improved position.
  2. Another system is to put in rods which afterwards need to be lengthened by having a small operation approximately every 6 months. A short general anaesthetic is needed each time it is lengthened.
  3. There is another system which has a motor built in to allow lengthening. The motor is controlled by an external magnetic controller which is placed on the skin and the rods lengthen. The lengthening is done in clinic with the child awake, every 3 months.

How long do they last and would the patient need further surgery?

Most patients will require further surgery either to insert a further growing system if the maximum length has been reached or to fuse the spine if the patient has nearly stopped growing.

Planned operations are when we take you back to theatre to do an expected operation such as lengthening the construct, or fusing the spine. Unfortunately, these systems also have a 40 – 50 percent chance of complications, and a 20 – 30 per cent chance of unplanned further surgery, mostly due to failure of the instrumentation because the spine is still mobile. The other main reasons for unplanned operations are infection in the wounds or around the metalwork, or because the scoliosis continues to get bigger as you grow.

 

References:

1. Systematic review of the complications associated with magnetically controlled growing rods for the treatment of early onset scoliosis. Eur Spine J (2018) 27:2062–2071

2. Growing rod concepts: state of the art. Eur Spine J (2013) 22 (Suppl 2):S118–S130

Finding out more

Your consultant spinal surgeon will discuss the available options in your particular case during your appointment.

It’s a good idea to jot down any questions you may have and bring them with you to clinic.

Contact

Spinal Nursing Team
0114 2267984

Orthotic Department
0114 2717271

Mr Breakwell, Mr Cole, Mr Athanassacopoulos, Mr Bayley, Miss Srinivas
Secretary 0114 2267981

Formetric scan advice
0114 226 0602

Switchboard 0114 2717000

Further resources:

Scoliosis Association (SAUK)
www.sauk.org.uk 
020 8964 5343

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Disclaimer

Please note this is a generic information sheet relating to care at Sheffield Children’s. The details in this resource may not necessarily reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If you have specific questions about how this resource relates to your child, please ask your doctor.

Resource number: SPN8

Resource Type: Article

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NHS

Western Bank
Sheffield
S10 2TH

United Kingdom

Switchboard: 0114 271 7000

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