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Which Method Should be Avoided to Prevent Children with a Short Stature?
The “fusion” procedure, which can otherwise be described as fixing the spine, elimination of movement, or stopping the growth, should not be performed in growing children to avoid leaving a short spine. Thus, if the brace cannot stop the curve, we try to correct the curve with screw and rod systems, and without the fusion procedure. This method is named “growing rod system”—essentially working like a brace placed underneath the skin. The spine, however, will continue to grow and the curve will continue to progress despite the implanted rods. This necessitates multiple periodic surgeries (every six months) during which the rods will be lengthened and the curved corrected. Ideally, this treatment should continue until the end of puberty, and fusion procedure should occur when growth declines or ceases.
What Method Prevents Repeated Operations? Is it Applied in our Country?
The method of magnetically controlled growing rods—a controlled lengthening of the special rods previously implanted into the spine— is performed using an externally created magnetic field, without the need to open the surgical site (or the spine). This enables rod implantation using one instead of multiple operations, and prevents the progression of the curve via periodic lenghtenings without opening the spine. Lengthening procedures can be performed in clinics without anesthesia. This method has arrived in our country and can be applied by me.
Can you Describe the Advantages of this Method for Children?
The surgical method without fusion should continue until the end of puberty. Then fusion of the spine should occur once the growth rate declines or stops. This is a very cumbersome and risky treatment method when performed with classical growing rods. When such a treatment is started at age 3 and continues until age 12, about 22 total operations needed. Previous clinical studies have shown that repeated operations create a great stress (posttraumatic stress disorder) on children and families, and may result in psychological problems. Therefore, externally growing rods will prevent repeated operations and related problems.
Who is Eligible for This Treatment?
This method can be applied to growing children. It can also serve as an alternative treatment method to replace braces in adolescent scoliosis. Applications in children so far have yielded successful results. Next, it will be used in children between ages 10 to 12 and curves between 30-40 degrees. This treatment does not guarantee an absense of surgical treatment of scoliosis, however it decreases the frequency of repeated operations in small children.