What exactly is my child's problem? What is Early-Onset Scoliosis?
Early-Onset Scoliosis (EOS) is the curvature of the spinal column to the sides which is more than 10 degrees and starts early in child’s life, most commonly before the age of 5. Sometimes, another pathology exists which causes scoliosis (i.e. congenital vertebral anomalies, problems of the muscles and nerves or brain etc.) and sometimes, no clear underlying problem will be identified (Idiopathic EOS)
What are the treatment options? Can my child totally avoid surgery?
Choices of treatment are different. Some children with stable, non-progressive curves need only observation on the regular basis. Some others with slowly progressive curves will be chosen to undergo brace or cast treatment. However, surgery is the only way to interfere with the course of progressive Early-Onset Scoliosis. Growing Rod surgery, VEPTR (Vertical Expandable Prosthetic Titanium Rod) and Shilla procedures are common procedures each with its specific cons and pros.
What is the Growing Rod (GR) surgery?
Growing Rod surgery is the implantation of two sets of rods on either side of the spine attached to the upper and lower spinal column vertebrae with hooks or screws (anchors) and without any fusion or instrumentation in between of those two terminal sites. The goal of the GR treatment is to correct the scoliosis at initial surgery as much as possible and then distract (lengthen) the spinal column on regular basis to induce growth of spinal column. Most of the patients will undergo a final definitive surgery when their growth plateaus and their treatments end.
How long should my child stay at hospital after the GR surgery?
It depends on the type of the surgery, general health condition of the patient before and after the surgery and treating physician’s discretion. Generally stating, after initial GR surgery patient will stay for 3-5 days. Most of the uneventful GR lengthening procedures, however, are performed on outpatient basis and the patient will be discharged the same day after being a few hours in hospital or surgery center.
Does my child need to wear brace after GR surgery?
Almost all patients need to wear a brace for 3 to 6 months after the initial GR surgery. This is to make sure that the bone healed and fused segments are ready for GR lengthening. However, we do not brace our patients after regular GR lengthening.
How long does the surgery take?
Depending on the complexity of the patient’s anatomy and underlying pathology, the initial GR surgery may take 2-6 hours but uneventful GR lengthening usually takes about 1 hour.
Will my child have some limitations in sports or physical activities?
Except the critical time of the first 3-6 months after initial GR surgery, we encourage our patients to return to mild to moderate non-contact and low risk sports they used to do (i.e. swimming, jogging and non-competitive running and cycling etc.). However, we advice our patients to avoid competitive and contact sports almost for the whole period of their GR treatment as accidental falls or sports contact can lead to rod breakage and implant failure.
What are the major adverse events after the GR surgery? Can my child get paralyzed?
GR surgery is a complex treatment for a very complex spine problem in young children. Minor complications like wound problem, superficial infection or rods/screws problem can occur in 10% to 30% of the patients but they usually do not need major and extensive surgery to be fixed. Major complications like neurological complications, deep surgical site infection and major GR failure happen less commonly but do need bigger operation. While we take every effort to avoid complications, theoretically anything can happen from minor to devastating complications.
When my child’s treatment will end?
The course of the GR treatment for each patient is different and depends on several factors i.e. age at initial surgery, the cause of scoliosis, the rate of deformity progression and occurrence of complications; however, it is usually from as low as 1-2 years to as high as 7-8 years.
What are the MAGECTM device and MCGR procedure? Can my child undergo this treatment in United States?
MAGECTM is a magnetically controlled growing rod which after initial implantation can be lengthened with an external set of strong magnets without the need to perform any operations. The system has been examined in both animal and humans and shown to be safe and effective. Currently, your child cannot undergo MCGR (Magnetically Controlled Growing Rod) procedure in the United States. The FDA has not approved the MAGECTM device yet for the use in US but efforts are underway to get its approval in near future.