Growth Rod Application for Early Onset Scoliosis

What is the Growth Rod Application for Early Onset Scoliosis?

Untreated early-onset scoliosis can lead to severe spinal malformations and serious medical complications. Although conservative approaches like bracing provide some protection in minimal scoliosis, they are ineffective for advanced cases. Growth rod application for early-onset scoliosis helps prevent spinal deformities while allowing the spine to grow naturally.

Growth rods are adjustable medical implants that spine surgeons insert to provide controlled spinal correction. The minimally invasive procedure periodically extends these rods to achieve spinal growth that matches natural developmental patterns for children during their growth spurts.

Benefits of Growth Rod Application:

Managing EOS requires a treatment approach that corrects spinal curvature and supports overall growth and development. Growth rod application for early-onset scoliosis provides a safe and effective approach to control scoliosis progression while maintaining flexibility.

• Controlled Spinal Alignment: Growth rods stabilise the spine and prevent worsening curvature. Gradually correcting misalignments reduces the risk of severe deformities and organ compression.

• Allows Natural Growth: Unlike spinal fusion, which restricts growth, growth rods expand with your natural skeletal development. This preserves height and prevents premature spinal stiffening.

• Improved Lung Function: Severe scoliosis can restrict lung expansion, leading to breathing difficulties. Growth rods create more space in the chest, supporting lung growth and improving respiratory function.

• Minimally Invasive Adjustments: Growth rods are lengthened periodically through minor outpatient procedures. These adjustments are quick, reducing recovery time and surgical trauma.

• Delays or Prevents Spinal Fusion: Early fusion can limit movement and lead to complications. Growth rods delay or eliminate the need for permanent spinal fusion, allowing for more natural spine development.

• Enhances Mobility and Quality of Life: This procedure improves posture, reduces pain, and maintains flexibility, enabling you to stay active and participate in daily activities more comfortably.

What Health Conditions Require Growth Rod Application for Early Onset Scoliosis?

EOS can arise from various underlying conditions requiring a tailored treatment approach. Growth rod application is designed to manage progressive spinal curvatures that threaten normal development and organ function.

Some of the key conditions where this procedure is recommended include:

• Idiopathic Early Onset Scoliosis: In cases where scoliosis develops without a known cause, growth rods provide controlled correction, preventing rapid curve progression while allowing spinal growth.

• Congenital Spinal Deformities: If spinal abnormalities occur at birth due to improper vertebral formation, growth rods offer a structured approach to managing deformities while maintaining flexibility.

• Neuromuscular Scoliosis: Conditions such as cerebral palsy or muscular dystrophy weaken the muscles supporting the spine. Growth rods stabilise spinal curvature, improving posture and reducing discomfort.

• Syndromic Scoliosis (e.g., Marfan Syndrome, Neurofibromatosis): Some genetic disorders cause connective tissue abnormalities, leading to scoliosis. Growth rods help maintain spinal alignment while addressing other associated complications.

• Thoracic Insufficiency Syndrome: When severe spinal curvature compresses the ribcage and restricts lung development, growth rods expand the chest cavity, allowing proper lung function.

Indications for Growth Rod Application:

The risk of spinal deformity, organ compression, and limited movement increases when the condition progresses rapidly to 40-50 degrees of curvature. If you have early-onset scoliosis that doesn't respond to bracing or physical therapy, you may be a candidate for growth rod surgery.

The decision to proceed with growth rod application depends on several factors, including age, spinal maturity, and curvature severity. Growth rods provide a structured, long-term solution if your scoliosis affects breathing or risks causing thoracic insufficiency syndrome. Early intervention helps ensure better spinal alignment and overall health.

How Does Growth Rod Application Work?

Growth rod application involves a structured surgical approach that ensures spinal correction while preserving flexibility. The procedure accommodates natural growth, making it a preferred solution for young children with progressive early-onset scoliosis.

The Surgical Approach and Placement of Growth Rods

The surgery begins with small incisions along the spine, through which specialised rods are inserted. These rods are anchored to the vertebrae using hooks or screws at the top and bottom of the curvature. The initial correction is performed during this procedure, setting the foundation for gradual spinal realignment. Unlike fusion surgery, this method does not permanently restrict movement, allowing continued flexibility. The rods are placed to minimise strain on surrounding muscles and tissues, ensuring a smooth postoperative recovery.

Non-Fusion Spinal Correction: Maintaining Flexibility

One key advantage of growth rod application is that it does not fuse the spine at an early age. Spinal fusion can severely limit movement and lead to long-term stiffness, which is particularly concerning for children still in their growth phase. Instead, growth rods allow for controlled expansion, ensuring the spine remains dynamic. Over time, the rods are adjusted to match natural growth, providing stability and mobility. This method helps preserve the ability to perform daily activities without significant restrictions.

Role of Expandable Rods in Managing Growth

Expandable rods are a crucial component of this procedure. These rods are designed to be lengthened periodically in an outpatient setting, usually every 6 to 12 months. This minimally invasive technique reduces recovery time and discomfort. The expansion process ensures that spinal growth continues to be aligned, preventing the progression of scoliosis while allowing overall body development. This approach minimizes the need for additional complex surgeries and improves long-term outcomes.

Pre-Procedure Guidelines

Preparing for growth rod application involves thorough medical evaluations and planning to ensure a safe and effective surgical outcome. Your spine specialist will assess your condition, discuss expectations, and provide detailed guidance on preoperative care. Proper preparation is essential to minimise risks and support a smooth recovery process.

Medical Evaluations and Imaging Studies

A comprehensive assessment is conducted to evaluate the severity of your scoliosis and determine the best surgical approach. This includes X-rays, MRIs, and CT scans to analyse spinal curvature and vertebral abnormalities. Blood tests assess overall health, while pulmonary function tests evaluate breathing capacity, mainly if scoliosis affects lung development. These evaluations help your surgeon customise the procedure to your specific needs.

Preoperative Counselling and Expectation Setting

Understanding the surgical process and recovery expectations is crucial. Your specialist will explain the step-by-step procedure, potential outcomes, and long-term care requirements. Discussions may include the number of expected rod lengthening procedures, lifestyle modifications, and emotional preparation. This ensures that you and your caregivers are mentally and physically ready for the journey.

Medication and Lifestyle Adjustments Before Surgery

Certain medications may need to be adjusted or temporarily discontinued before surgery to reduce the risk of bleeding and complications. Non-steroidal anti-inflammatory drugs (NSAIDs) and blood thinners are typically avoided. Additional precautions may be necessary if you have underlying conditions such as asthma or neuromuscular disorders. Maintaining a healthy diet and staying active within safe limits can also support better postoperative recovery.

Preparing for Hospital Stay and Recovery

Since growth rod application requires a hospital stay, packing essentials such as comfortable clothing, assistive devices, and personal hygiene items can ease the transition. Arrangements should be made for post-surgical care at home, including preparing a resting space with minimal movement obstacles. Understanding hospital protocols, pain management plans, and rehabilitation schedules in advance can help you confidently approach the procedure.

The Procedure: Step-by-Step

Growth rod application is a carefully planned surgery that corrects spinal curvature while preserving natural growth. The procedure involves precisely placing expandable rods that can be adjusted periodically to accommodate spinal development.

Anaesthesia and Patient Positioning

The surgery begins with the administration of general anaesthesia to ensure a pain-free and comfortable experience for the patient.

You will be positioned face down on a specialised surgical table, which provides optimal spinal access. Proper positioning minimises pressure on vital structures and allows precise correction of curvature.

Surgical Incision and Exposure of the Spine

A controlled incision is made along the back, exposing the affected vertebrae. The length of the incision depends on the severity and location of your scoliosis. Soft tissues and muscles are carefully retracted to access the spinal column while preserving surrounding structures to promote faster healing.

Placement of Anchoring Screws and Rods

Anchoring screws or hooks are securely attached to the upper and lower portions of the curved section of the spine. These fixation points serve as anchors for the growth rods. The placement of these anchors is crucial for stability and future adjustments.

Adjusting the Rods for Spinal Correction

The initial correction is performed by gently aligning the spine to a more natural position. The rods are then attached to the anchoring screws, applying controlled pressure to reduce spinal curvature while maintaining flexibility. This step ensures that your spine continues to grow in a guided manner.

Securing the Growth Rods in Place

Once the desired spinal alignment is achieved, the rods are securely fastened. Expandable rods are selected based on growth potential, allowing for periodic lengthening in future procedures. The final adjustments ensure optimal correction without compromising movement.

Closure and Post-Surgical Care

The incision is closed using sutures or staples, and sterile dressings are applied to prevent infection. You will be closely monitored in the recovery unit for vital signs, pain levels, and early signs of complications. A tailored postoperative plan, including pain management and mobility guidance, is implemented to support healing.

Recovery and Post-Procedure Guidelines

Post-surgical recovery is critical to ensuring the success of growth rod application. While initial healing takes a few weeks, long-term care and rehabilitation play a significant role in maintaining spinal alignment and mobility.

What to Expect in the Immediate Postoperative Period?

After surgery, you will spend some time in the intensive care unit (ICU) for close monitoring. Pain control measures, oxygen support, and intravenous fluids will be administered as needed. Gradual movement is encouraged to prevent complications like blood clots and respiratory issues.

Pain Management and Early Mobilisation

Pain is managed using a combination of medications, including opioids, muscle relaxants, and non-opioid analgesics. Once your condition is stable, you will be encouraged to sit up, stand, and walk with assistance. Early mobilisation improves circulation and speeds up the recovery process.

Wound Care and Activity Restrictions

Proper wound care is essential to prevent infections and promote healing. Incision sites should be kept clean and dry, and dressings should be changed per medical instructions. Strenuous activities, heavy lifting, and bending should be avoided during the initial recovery phase to protect spinal stability.

Long-Term Rehabilitation and Physical Therapy

Once the surgical site heals, physical therapy enhances strength, flexibility, and posture. Exercises are tailored to improve spinal support muscles while avoiding excessive strain. Long-term rehabilitation ensures that you regain mobility and adjust to spinal changes comfortably.

Follow-Up and Lengthening Procedures

Growth rod application is not a one-time surgery. Regular follow-ups and periodic adjustments are necessary to accommodate spinal growth and maintain correction.

Regular Assessments and Imaging Studies

Routine follow-ups involve clinical evaluations and imaging studies, such as X-rays, to assess spinal alignment and the position of the growth rods. These assessments help determine the timing for lengthening procedures and detect potential issues early.

Rod Expansion Procedures: How They Work

Rod lengthening procedures are minimally invasive and performed every 6 to 12 months. The rods are extended to match your growth through a small incision or external magnet-based adjustments (for magnetic rods), preventing spinal curvature from worsening further.

Frequency of Adjustments Based on Growth Patterns

The frequency of rod lengthening depends on your rate of growth and the severity of scoliosis. Regular adjustments ensure that spinal development remains on track while minimising the need for additional surgeries.

Potential Risks and Limitations of Growth Rod Application

While growth rod application is a highly effective treatment for EOS, specific risks and limitations should be carefully considered.

• Risk of Infection - Post-surgical infections are possible, requiring antibiotics or, in severe cases, rod removal.

• Rod Breakage or Loosening - Over time, mechanical failure of the rods may occur, necessitating replacement or revision surgery.

• Limited Spinal Mobility - Although flexibility is maintained, minor restrictions in movement may be observed.

• Need for Future Fusion Surgery - In some cases, spinal fusion may still be required in adolescence once growth is complete.

• Complications from Repeated Surgeries - Multiple lengthening procedures increase the risk of scarring and surgical stress.

Why Choose Manipal Hospitals for Growth Rod Application?

Choosing the right medical centre for scoliosis treatment is essential to ensure the best outcomes. Manipal Hospitals provides expert-led, multidisciplinary care in spinal deformity correction, offering state-of-the-art surgical solutions tailored to your needs.

• Expertise in Paediatric Spine Surgery: Our team includes spine specialists in Bangalore with extensive experience managing complex EOS cases using the latest surgical techniques.

• Advanced Technology and Minimally Invasive Procedures: We utilise cutting-edge imaging systems, robotic-assisted spine surgeries, and magnetic rod lengthening to enhance precision and reduce recovery time.

• Comprehensive Preoperative and Postoperative Care: From diagnostic evaluations to rehabilitation, our holistic care approach ensures seamless treatment and long-term support.

• Multidisciplinary Team Approach: A coordinated team of spine surgeons, physiotherapists, pulmonologists, and paediatric specialists work together to optimise your treatment plan.

• Proven Success in Growth Rod Applications: We have a strong track record of successful scoliosis corrections with trusted, results-driven care that prioritises your health and mobility.

Growth rod application at Manipal Hospitals is designed to give you the best possible spinal correction while ensuring long-term well-being and an improved quality of life.