Early Onset Scoliosis

What is Early Onset Scoliosis?

In children with early onset scoliosis, the spine curves too rapidly during skeletal growth. If a fusion of the spine is performed at such a young age, the child’s lungs will continue to grow and the rib cage won't be able to expand with them. Also, a deformity called “crank-shaft deformity” will occur where the front of the chest continues to grow and rotate while the back stays fused. Therefore, a limited fusion with instrumentation that can grow with the patient can be placed along the spine to help direct the growth of the spine.

VIDEO: Learn more about Early Onset Scoliosis

Shilla Technique

The Shilla technique uses two rods that grow as the spine grows. In the past, growing rods were used which required many surgeries for the surgeon to manually lengthen the hardware as the patient grew. The Shilla hardware hopes to minimize the amount of surgeries needed during the growth period of a child, therefore minimizing the risk of infection and hardware failure.

Growing Rods

In skeletally immature children who have a significant curve of their spine with marked progression, a limited fusion can be performed to help keep the curve from progressing further. The goal is to lengthen the spinal hardware with the natural growth of the spine and hopefully direct the spine’s growth in a straighter plan. This technique does require frequent surgeries for the hardware lengthening at seven- to nine-month intervals. Once the patient is skeletally mature, the final fusion with curvature correction can be performed with the permanent hardware.

Sample Cases of Early Onset Scoliosis -- 52-Degree Curve of the Thoracic Spine

Image A & B

Six-year-old patient with a 52-degree curve of the thoracic spine. The curve continued to progress rapidly with growth. A limited fusion using the Shilla technique was performed. Then, a week later, permanent hardware was placed.

Image C

One week after the surgery, his deformity is much improved.

Image D

Two weeks after surgery, the patient still has his surgical bandages in place. He is much more balanced and his deformity is well corrected.

Image E

Six months after surgery, the patient's spine is still straight without any evidence that his deformity is recurring.

Sample Case Using Growing Rod Placement

Image A & B

Images show spinal curvature prior to the placement of growing rods.

Image C & D

Post-operatively after the growing rods are placed. The patient returns to the operating room every eight to ten months for lengthening of the hardware. The lengthening surgery is same-day surgery without an overnight hospital stay required.

Sample Case: Growing Rods #2

Image A & B

Images show spinal curvature prior to the placement of growing rods.

Image C & D

Post-operatively after the growing rods are placed. Patient is still undergoing his lengthenings and doing very well.