by Ahmed Sayed Ahmed El Shamy, Mohamed Ramadan El-Fishawy, Mohamed Ahmed Abd elfattah, Ibrahim Elsayed Morsi, Mohammed Abdelgwad Ismail Emara, Ali Abd Elwahed Zaki, Mohamed Harby Abd Elghani Elsherif, Ahmed Ibrahim Abdel Salam Hasan
ABSTRACT
This prospective study endeavors to prove that Definitive Spinal Fusion (DSF) as a method for the management of progressive Idiopathic Early Onset Scoliosis (IEOS) in cases aged 8-11 years old represents a good option. Growth-friendly surgeries such as Growing Rods (GR) which are the trend now for the management of EOS aim to preserve spinal growth and lung development while correcting the curve, but at the expense of a high risk of complications such as loss of fixation, infection, progressive kyphosis, as well as inadvertent fusion. DSF offers better curve correction, avoids the complications associated with growth-sparing techniques, and prevents further curve progression with no more growth for the fused segments. Twenty IEOS patients with a major coronal curve angle of between 50 and 90 degrees in the age group of 8-11 years were included in this study. The mean age at the time of surgical intervention has been found to be 9.8 years, with a standard deviation (SD) of 0.8 years, encompassing a range of 8 to 11 years. A subsequent observational period spanning a duration of three years was conducted, during which pertinent data was collected. The mean age of the subjects at the conclusion of said follow-up period was determined to be 13 years, with a standard deviation of 0.8 years. The mean coronal Cobb angle demonstrated a statistically significant improvement (p0.001) from a preoperative mean of 2.6± 0.7 to a postoperative mean of 1.1 ± 0.2. No unplanned surgeries were required due to complications. The primary concern in the past with earlier fusion techniques in a skeletally immature case was the risk of loss of height increase or curve progression (either adding on or crankshaft). Using pedicle screws for definitive fusion resulted in better curve correction, adding to the height with no reported curve progression or significant complications. Therefore, the motivation for using growing rods in the age group 8-11 will decrease.
